Here are the screening tests and immunizations that most women at age 65 and older need. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion. In addition, major organizations may vary in recommendations on these prevention guidelines.
Who needs it
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 use or misuse
At routine exams
Every year if your blood pressure reading is less than 120/80 mm Hg
If your blood pressure reading is higher than normal, follow the advice of your healthcare provider
Mammogram every other year or you may choose to continue mammograms every year
According to the American Cancer Society (ACS), women older than 65 who have had regular screening with normal results do not need to be screened for cervical cancer. Once screening is stopped, it should not be started again.
Discuss with your healthcare provider
Women at increased risk for infection
At routine exams if at risk
All women of average risk and in good health in this age group, through age 75. For women ages 76 to 85, talk with your healthcare provider about continued screening. For women 85 and older, experts don't advise screening.
The ACS recommends:
Several tests are available and used at different times.
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 plus 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 doctor 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 doctor about your health history and what colorectal cancer screening schedule is best for you.
All adults who have access to a clinical practice that has staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
Sexually active women who are at increased risk for infection
Anyone at increased risk for infection
Anyone at increased risk; 1 time for those born between 1945 and 1965
High cholesterol and triglycerides
All women ages 20 and older at increased risk for coronary artery disease
At least every 5 years, or more frequently if recommended by your healthcare provider
Adults between the ages of 50 to 80 who are in fairly good health and are at higher risk for lung cancer who:
Currently smoke or have quit within the past 15 years, and
Have a 20-pack year history of smoking (1 pack/day for 20 years or 2 packs/day for 10 years)
Yearly lung cancer screening with a low-dose CT scan (LDCT); talk with your healthcare provider about your risk and situation
All women ages 65 and older
Bone density test at age 65, then follow-up as recommended by healthcare provider
Check with your healthcare provider
Every 1 to 2 years; if you have a chronic disease, check with your healthcare provider for exam frequency
Aspirin for prevention of cardiovascular problems
Women ages 55 to 79 when the potential benefits from reducing ischemic strokes outweigh the potential harm from an increase in gastrointestinal hemorrhage
Diet and exercise
Adults who are overweight or obese
When diagnosed and at routine exams
Fall prevention (exercise, vitamin D supplements)
All women in this age group
Sexually transmitted diseases prevention
All women at increased risk
Tobacco use and tobacco-related disease
Tetanus/diphtheria/pertussis (Td/Tdap) booster
Td: Every 10 years
Tdap is recommended if you are in contact with a child 12 months or younger. Either Td or Tdap can be used if you have no contact with infants.
All adults age 65 and older who have no previous infection or documented vaccinations*
Two doses; second dose should be given at least 4 weeks after the first dose
Yearly, when the vaccine becomes available in the community
Hepatitis A vaccine
People at risk
Two doses given 6 months apart
Hepatitis B vaccine
Three 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)
Haemophilus influenzae Type B (HIB)
Women at increased risk for infection, talk with your healthcare provider
1 to 3 doses
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)
All adults age 65 and older
1 dose of each vaccine
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.