Prevention Guidelines for Women 50–64

Here are the screening tests and immunizations that most women ages 50 to 64 need. A screening test is done to find possible health problems or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to lower the risk of disease, or to find it early enough to treat it most effectively. Screening tests are not diagnostic. But they are used to find out if more testing is needed. Health counseling is vital, too. You and your healthcare provider may decide that a different schedule is best for you. But this plan can guide your discussion.

Screening	Who needs it	How often
Type 2 diabetes or prediabetes	All adults starting at age 45 and adults without symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes	At least every 3 years
Alcohol misuse	All adults	At routine exams
Blood pressure	All adults	Yearly checkup if your blood pressure is normal. Normal blood pressure is less than 120/80 mmHg. If your blood pressure reading is higher than normal, follow the advice of your healthcare provider.
Breast cancer	All women	Yearly mammogram should be done until age 54. At age 55, switch to mammograms every other year. Or you may choose to continue yearly mammograms.
Cervical cancer	All women, except those who have had a hysterectomy with removal of the cervix for reasons not related to cervical cancer and have no history of cervical cancer or serious precancer	Pap test every 3 years or Pap test with human papillomavirus (HPV) test every 5 years or primary HPV testing every 5 years, or Pap test with reflex HPV test every 3 years
Chlamydia	Women at a higher risk for infection	At routine exams
Colorectal cancer	All women of average risk in this age group	According to the American Cancer Society (ACS): For tests that find polyps and cancer: Colonoscopy every 10 years (recommended) or . Flexible sigmoidoscopy every 5 years, or CT colonography (virtual colonoscopy) every 5 years For tests that primarily find cancer: Yearly fecal occult blood test, or Yearly fecal immunochemical test every year, or Stool fecal immunochemical test with DNA test, every 3 years You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your provider about which test is best for you. Some people should be screened using a different schedule because of their personal or family history. Talk with your provider about your health history and what colorectal cancer screening schedule is best for you.
Depression	All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up	At routine exams
Gonorrhea	Sexually active women at a higher risk for infection	At routine exams if at risk
Hepatitis C	Adults at a higher risk; 1 time for those born between 1945 and 1965	At routine exams if at risk
HIV	All women	At routine exams if at risk
High cholesterol and triglycerides	All women ages 45 and older at a higher risk for coronary artery disease	At least every 5 years
Obesity	All adults	At routine exams
Lung cancer	Adults age 55 to 74 who in fairly good health and are at higher risk for lung cancer defined as current smokers or persons who have quit within past 15 years, and have a 30-pack-year smoking history (Eligibility criteria may vary across major organizations; Age limit may extend to age 80.) Talk with your healthcare provider for more information.	Yearly lung cancer screening with a low-dose CT scan (LDCT)
Osteoporosis, postmenopausal women	Women at age 60 who are at a higher risk for fractures caused by osteoporosis	Check with your health care provider
Syphilis	Adults at a higher risk for infection	At routine exams if at risk
Tuberculosis	Adults at a higher risk for infection	Check with your healthcare provider.
Vision	All adults5	Check with your healthcare provider for exam frequency.

Counseling	Who needs it	How often
Aspirin for prevention of cardiovascular problems	At-risk adults Recommended for women ages 55 to 79 years when the potential benefit of reducing strokes outweighs the potential harm of an increase in gastrointestinal bleeding	When risk is identified; talk with your healthcare provider before starting
Breast cancer, chemoprevention	Women at high risk	When risk is identified
BRCA mutation testing for breast and ovarian cancer susceptibility	Women with a higher risk	When risk is identified
Diet and exercise	Women who are overweight or obese	When diagnosed
Sexually transmitted disease prevention	Adults at a higher risk for infection	At routine exams
Tobacco use and tobacco-related disease	All adults	Every exam
Alcohol use and alcohol-related disease	All adults	Every exam

Immunization	Who needs it	How often
Haemophilus influenzae B type	At risk adults	1 to 3 doses
Tetanus/diphtheria/pertussis (Td/Tdap) booster)	All adults	One-time Tdap booster, then Td or Tdap every 10 years
Measles, mumps, rubella (MMR)	Adults in this age group through their late 50s who have no previous infection or documented vaccinations	1 to 2 doses
Chickenpox (varicella)	Adults ages 50 to 64 who have no previous infection or documented vaccinations	2 doses; the second dose should be given at least 4 weeks after the first dose
Flu vaccine (seasonal)	All adults	Yearly, when the vaccine becomes available in the community
Hepatitis A vaccine	People at risk	2 doses given at least 6 months apart
Hepatitis B vaccine	High risk adults	3 doses; second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)
Meningococcal	People at risk	1 or more doses
Pneumococcal (PCV13) Pneumococcal (PPSV23)	People at risk	PCV13: 1 dose ages 19 to 65 (protects against 13 types of pneumococcal bacteria) PPSV23: 1 to 2 doses through age 64, or 1 dose at 65 or older (protects against 23 types of pneumococcal bacteria)
Recombinant zoster vaccine (RZV)	All women ages 50 and older	2 doses; the 2nd dose is given 2 to 6 months after the first. This is given even if you've had shingles before or had a previous zoster live vaccine.