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Prevention Guidelines, Women Ages 65 and Older

Screening tests and vaccines are an important part of managing your health. A screening test is done to find possible disorders 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 reduce the risk of disease, or to detect it early enough to treat it most effectively. Screening tests are not considered diagnostic, but are used to determine if more testing is needed. Health counseling is essential, too. Below are guidelines for these, for women ages 65 and older. Talk with your healthcare provider to make sure you’re up to date on what you need.

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All women beginning at age 45 and women 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

Type 2 diabetes

All women with prediabetes

Every year

Unhealthy alcohol use

All women in this age group

At routine exams

Blood pressure

All women in this age group

Yearly checkup if your blood pressure is normal

Normal blood pressure is less than 120/80 mm Hg

If your blood pressure reading is higher than normal, follow the advice of your healthcare provider

Breast cancer

All women of average risk

Mammograms should be done every 1 or 2 years. Talk with your healthcare provider about your risk factors and how often you need the test and for how long.

Cervical cancer

Only women who had abnormal screening results before age 65

Talk with your healthcare provider

Chlamydia

Women at increased risk for infection

At routine exams

Colorectal cancer

All women at average risk in this age group through age 75 who are in good health. For women ages 76 to 85, talk with your healthcare provider about whether to continue screening. For women 85 and older, screening is not needed.

Multiple tests are available and are used at different times. Possible tests include:

  • Flexible sigmoidoscopy every 5 years, or

  • Colonoscopy every 10 years, or

  • CT colonography (virtual colonoscopy) every 5 years, or

  • Yearly fecal occult blood test, or

  • Yearly fecal immunochemical test every year, or

  • Stool DNA test, every 3 years

If you choose a test other than a colonoscopy and have an abnormal test result, you will need to follow-up with a colonoscopy. Talk with your healthcare provider which test is best for you.

Some people should be screened using a different schedule because of their personal or family health history. Talk with your healthcare provider about your health history.

Depression

All women in this age group

At routine exams

Gonorrhea

Sexually active women at increased risk for infection

At yearly routine exams

Hepatitis C

Anyone at increased risk; 1 time for those born between 1945 and 1965

At routine exams

High cholesterol or triglycerides

All women in this age group who are at risk for coronary artery disease

At least every 5 years; talk with your healthcare provider about your risk

HIV

Women at increased risk for infection

At routine exams; talk with your healthcare provider about your risk

Lung cancer

Adults ages 55 to 74 who are in fairly good health and are at higher risk for lung cancer

  • Currently smoke or have quit within the past 15 years

  • 30-pack year smoking history

Eligibility criteria and age limit (possibly up to age 80) may vary across major organizations

Yearly lung cancer screening with a low dose CT scan (LDCT); talk with your healthcare provider

Obesity

All women in this age group

At yearly routine exams

Osteoporosis

All women in this age group

Routinely done every 2 years, but repeat as advised by your healthcare provider

Syphilis

Women at increased risk for infection

At routine exams; talk with your healthcare provider

Thyroid-stimulating hormone (TSH)

Only women in this age group with symptoms of thyroid dysfunction

Talk with your healthcare provider

Tuberculosis

Women at increased risk for infection

Talk with your healthcare provider

Vision

All women in this age group

Every 1 to 2 years; if you have a chronic health condition, ask your healthcare provider if you need exams more often

Vaccine

Who needs it

How often

Chickenpox (varicella)

All women in this age group who have no record of this infection or vaccine

2 doses; second dose should be given at least 4 weeks after the first dose

Hepatitis A

Women at increased risk for infection

2 or 3 doses (depending on the vaccine) given at least 6 months apart; talk with your healthcare provider

Hepatitis B

Women at increased risk for infection

2 or 3 doses (depending on the vaccine); second dose should be given 1 month after the first dose; if a the third dose, it should be given at least 2 months after the second dose and at least 4 months after the first dose

Haemophilus influenza type B (HIB)

Women at increased risk for infection

1 to 3 doses; talk with your healthcare provider

Influenza (flu)

All women in this age group

Once a year

Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)

All women in this age group

PPSV 23: women who have not been vaccinated or have not had infection

PCV 13: women at increased risk for infection

PPSV: 1 dose at age 65 or older

PCV 13: 1 dose at age 65 or older; talk with your healthcare provider

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All women in this age group

Td every 10 years, or a 1-time dose of Tdap instead of a Td booster after age 18, then Td every 10 years

Zoster (shingles)

All women in this age group

2 vaccines are available:

  • Recombinant zoster vaccine (RZV; Shigrix) is recommended as the preferred shingles vaccine. It's given in a series of 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.

  • Zoster live vaccine live (ZVL; Zostavax) may be given to healthy adults over age 60. It's given in one dose.

Counseling

Who needs it

How often

Diet and exercise

Women who are overweight or obese

When diagnosed, and then at routine exams

Fall prevention (exercise and vitamin D supplements)

All women in this age group

At yearly routine exams

Sexually transmitted infection prevention

Women at increased risk for infection–talk with your healthcare provider

At routine exams

Use of daily aspirin

Women up to age 70 who are at high risk for cardiovascular problems and not at increased risk for bleeding as identified by your healthcare provider

When your risk is known

Use of tobacco and the health effects it can cause

All women in this age group

Every exam

Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Horowitz, Diane, MD
Date Last Reviewed: 7/1/2020
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