Health Encyclopedia

Health screenings for women age 65 and older

Definition

You should visit your health care provider from time to time, even if you are healthy. The purpose of these visits is to:

• Screen for medical issues
• Assess your risk for future medical problems
• Encourage a healthy lifestyle
• Update vaccinations and other preventive care services
• Help you get to know your provider in case of an illness

Alternative Names

Health maintenance visit - women - over age 65; Physical exam - women - over age 65; Yearly exam - women - over age 65; Checkup - women - over age 65; Women's health - over age 65; Preventive care exam - women - over age 65

Information

Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.

There are specific times when you should see your provider or receive specific health screenings. The US Preventive Services Task Force publishes a list of recommended screenings. Below are screening guidelines for women age 65 and older.

BLOOD PRESSURE SCREENING

Have your blood pressure checked at least once every year. Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. You can also check your blood pressure using the automated machines at local grocery stores and pharmacies.

Ask your provider if you need your blood pressure checked more often if:

• You have diabetes, heart disease, kidney problems, or are overweight or have certain other health conditions
• You have a first-degree relative with high blood pressure
• You are Black
• Your blood pressure top number is from 120 to 129 mm Hg, or the bottom number is from 70 to 79 mm Hg

BREAST CANCER SCREENING

• Women may do a monthly breast self-exam. However, experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.
• Your provider may do a clinical breast exam during your preventive exam. Experts do not agree on the benefit of a breast examination.
• Women up to age 75 should have a mammogram every 1 to 2 years, depending on their risk factors, to check for breast cancer.
• Experts do not agree on the benefits of having a mammogram for women age 75 and older. Some do not recommend having mammograms after this age. Others recommend mammography for women in good health. Talk to your provider about what is best for you.

CERVICAL CANCER SCREENING

After age 65, most women who have not been diagnosed with cervical cancer or precancer can stop having screening tests, as long as:

• They have had 3 consecutive negative Pap test results or 2 consecutive negative PAP and HPV tests results within 10 years
• The most recent test occurred within 5 years

CHOLESTEROL SCREENING

If your cholesterol level is normal, have it rechecked at least every 5 years.

You should have repeat testing sooner if:

• Changes occur in your lifestyle (including weight gain and diet)
• You have high cholesterol, diabetes, heart disease, kidney problems, or certain other health conditions

COLORECTAL CANCER SCREENING

Until age 75, you should have screening for colorectal cancer on a regular basis. If you are age 76 or older, you should ask your doctor if you should receive screening. Several tests are available for colorectal cancer screening:

• A stool-based fecal occult blood (gFOBT) or fecal immunochemical test (FIT) every year
• A stool sDNA-FIT test every 1 to 3 years
• Flexible sigmoidoscopy every 5 years or every 10 years with stool testing with FIT done every year
• CT colonography (virtual colonoscopy) every 5 years
• Colonoscopy every 10 years

You may need a colonoscopy more often if you have risk factors for colon cancer, including:

• Ulcerative colitis
• A personal or family history of colorectal cancer
• A history of growths in your colon called adenomatous polyps

DENTAL EXAM

• Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.

DIABETES SCREENING

You should be screened for diabetes every 3 years.

You may be tested more often if you have other risk factors for diabetes, such as:

• A first degree relative with diabetes
• You are overweight or have obesity, high blood pressure, prediabetes, or a history of heart disease

EYE EXAM

• Have an eye exam every 1 to 2 years. Your provider may recommend more frequent eye exams if you have vision problems or glaucoma risk.
• Have an eye exam that includes an examination of your retina (back of your eye) at least every year if you have diabetes.

HEARING TEST

• Have your hearing tested if you have symptoms of hearing loss.

IMMUNIZATIONS

Commonly needed vaccines include:

• Flu shot: get one every year
• COVID-19 vaccine: ask your doctor what is best for you
• Pneumococcal vaccines: you should receive this vaccine
• Shingles (herpes zoster) vaccine: at or after age 50
• Tetanus-diphtheria and acellular pertussis (Tdap) vaccine: have as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent
• Tetanus-diphtheria: have a booster (or Tdap) every 10 years

INFECTIOUS DISEASE SCREENING

Screening for hepatitis C:

• All adults ages 18 to 79 should get a one-time test for hepatitis C.

Screening for human immunodeficiency virus (HIV):

• All people ages 15 to 65 should get a one-time test for HIV

Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and other infections.

LUNG CANCER SCREENING

You should have an annual screening for lung cancer with low-dose computed tomography (LDCT) if:

• You are age 50 to 80 years AND
• You have a 20 pack-year smoking history AND
• You currently smoke or have quit within the past 15 years

OSTEOPOROSIS SCREENING

• All women age 65 or older should have a bone density test (DEXA scan).
• Ask your provider which exercises or other interventions can help prevent osteoporosis or bone fractures.

PHYSICAL EXAMS

All adults should visit their provider from time to time, even if they are healthy. The purpose of these visits is to:

• Screen for diseases
• Assess risk of future medical problems
• Encourage a healthy lifestyle
• Update vaccinations and other preventive care services
• Maintain a relationship with a provider in case of an illness

In addition:

• Your blood pressure should be checked at least every year.
• Your height, weight, and body mass index (BMI) should be checked at every exam.

During the exam, your provider will ask questions about:

• Depression and anxiety
• Diet and exercise including exercises to improve your balance and reduce your risk of falling
• Alcohol and tobacco use
• Safety, such as use of seat belts and smoke detectors and intimate partner violence
• Whether you have had any falls or are afraid of falling
• Whether you have symptoms of urinary incontinence
• Your medicines and risk for interactions

SKIN EXAM

• Your provider may check your skin for signs of skin cancer, especially if you're at high risk.
• People at high risk include those who have had skin cancer before, have close relatives with skin cancer, or have a weakened immune system.

References

Advisory Committee on Immunization Practices. Adult immunization schedule by age. Recommendations for ages 19 years or older, United States, 2023. www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. Updated April 27, 2023. Accessed July 30, 2023.

American Academy of Ophthalmology website. Clinical statement: comprehensive adult medical eye examination PPP 2020. www.aao.org/education/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation-ppp. Updated November 2020. Accessed July 30, 2023.

American Cancer Society website. Breast cancer early detection and diagnosis: American Cancer Society recommendations for the early detection of breast cancer. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Updated January 14, 2022. Accessed July 30, 2023.

American College of Obstetricians and Gynecologists (ACOG) website. FAQ178: Mammography and other screening tests for breast problems. www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems. Updated July 2022. Accessed July 30, 2023.

American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated April 2021. Accessed July 30, 2023.

American Dental Association website. Your top 9 questions about going to the dentist -- answered! www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed July 30, 2023.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 12.

Brown HL, Warner JJ, Gianos E, et al; American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843-e852. PMID: 29748185 pubmed.ncbi.nlm.nih.gov/29748185/.

ElSayed NA, Aleppo G, Aroda VR, American Diabetes Association, et al. Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S19-S30. PMID: 36507649. pubmed.ncbi.nlm.nih.gov/36507649/.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2019 Jun 25;73(24):3237-3241]. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/30423393/.

Meschia JF, Bushnell C, Boden-Albala B; American Heart Association Stroke Council; et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated June 7, 2023. Accessed July 30, 2023.

Studenski S, Van Swearingen J. Falls. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 103.

US Preventive Services Task Force website. A and B recommendations. www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations. Accessed July 30, 2023.

US Preventive Services Task Force website. Falls prevention in community-dwelling older adults: interventions. www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-in-older-adults-interventions. Published April 17, 2018. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: medication use to reduce risk. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-medications-for-risk-reduction. Updated September 3, 2019. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. Updated January 11, 2016. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Cervical cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Updated August 21, 2018. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Updated May 18, 2021. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Hepatitis C virus infection in adolescents and adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Published March 2, 2020. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Human immunodeficiency virus (HIV) infection: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Published June 11, 2019. Accessed July 30, 2023.

US Preventive Services Task Force website. Hypertension in adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening. Published April 27, 2021. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement: Lung cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Updated March 9, 2021. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Osteoporosis to prevent fractures: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening. Updated June 26, 2018. Accessed July 30, 2023. 

US Preventive Services Task Force website. Final recommendation statement. Prediabetes and type 2 diabetes: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes. Updated August 24, 2021. Accessed July 30, 2023.

US Preventive Services Task Force website. Final recommendation statement. Skin cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/skin-cancer-screening. Updated April 18, 2023. Accessed July 30, 2023.

Whelton PK, Carey RM, Mancia G, Kreutz R, Bundy JD, Williams B. Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines: comparisons, reflections, and recommendations. Circulation. 2022;146:868-877. DOI: 10.1161/CIRCULATIONAHA.121.054602. PMID 35950927. pubmed.ncbi.nlm.nih.gov/35950927/.

Review Date:8/1/2023
Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 04/18/2023. Internal review and update on 08/01/23.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.