A lot of the day-to-day care that helps you lead a long and full life happens before anything’s actually wrong with your health.
Unfortunately, millions of Americans don’t keep up with their recommended preventive tests and screenings, according to the Office of Disease Prevention and Health Promotion. Those exams can help you protect everything from your teeth to your heart to your eyes–and more.
Here are the tests and screenings recommended for women between 30 and 70, assuming you’re at average risk for different health conditions. If you’re at a higher risk for any diseases, talk to your doctor about an appropriate screening schedule.
In your 30s
The U.S. Preventive Services Task Force (USPSTF), an independent panel of experts that issues evidence-based guidelines on disease prevention, recommends that women ages 21 to 65 get a Pap smear every three years. The test detects abnormal changes in cervical cells that might signal pre-cancer or early cancer.
After 30, you can opt for a combination Pap smear and test for the human papillomavirus (HPV), the virus that can cause genital warts and cervical cancer. “If both of these are negative, you can repeat them every five years,” says Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center in Houston. “That would apply all the way through age 65.”
Since 2016, the USPSTF has recommended that all adults over the age of 18–including pregnant and postpartum women–be screened for depression. Your primary care doctor can do this by asking a set of simple questions. “If [patients] screen positive … we proceed with further questioning,” explains Marie Ramas, MD, a practising family physician in Nashua, New Hampshire.
The USPSTF found that routine screening led to improvements in treatment and outcomes for people identified as having depression.
The American Dental Association recommends visiting your dentist at least once or twice a year to get a cleaning and a check for plaque, gum disease, and other oral health problems. But your teeth can also provide clues about osteoporosis and even cancer that your dentist might be the first person to spot.
Some people need more frequent dental exams. Check with your dentist about an optimal schedule for you.
Blood pressure screening
Recommendations on blood pressure screening vary slightly among different organizations. The USPSTF suggests getting your blood pressure tested every three to five years starting at age 18 (or more often if you have risk factors for high blood pressure or if the reading is on the high end of normal) and then moving to annual testing at age 40.
The American Heart Association recommends starting at age 20 and redoing the test at least once every two years.
A fasting lipoprotein profile or panel measures total cholesterol as well as both LDL (“bad”) cholesterol and HDL (“good”) cholesterol after a brief period without eating.
The American Heart Association recommends getting a baseline panel at age 20, then repeating the test every four to six years for people at average risk of high cholesterol.
There are no official recommendations for skin exams; in 2016, the USPSTF concluded there wasn’t enough evidence to recommend routine visits to a dermatologist for people at average risk of skin cancer who don’t have any symptoms.
However, the American Academy of Dermatology encourages everyone to do regular skin self-checks and to see a dermatologist if you notice any changes on your skin.
If you’ve never been tested for HIV, now’s the time to get screened. Everyone between 15 and 65 should be screened for HIV at least once, according to the USPSTF, with repeat tests for those at higher risk of infection. There are no specific guidelines on how often screenings should take place, so talk to your doctor about what’s right for you.
All pregnant women should also be tested for HIV. “It’s just so high stakes for mom and for the baby,” says Leila Hajjar-Nolan, MD, director of analytics for women’s health services at Henry Ford Health System in Dearborn, Michigan. If a mom-to-be is HIV-positive, there are treatment options that can help make sure the virus isn’t passed to the baby.
In your 40s
There are still some conflicting opinions about when women should start getting mammograms to screen for breast cancer and how often they should be repeated.
The USPSTF recommends mammograms every two years for women at average risk of breast cancer starting at age 50 and continuing until age 74. The organization says that the decision to have mammograms before that “should be an individual one.”
The American Cancer Society says women ages 40 to 44 should be able to choose if they want to have annual mammography screening; women ages 45 to 54 should get annual screening; women 55 and older can continue yearly mammograms or switch to every other year.
MD Anderson Cancer Center and the National Comprehensive Cancer Network recommend annual mammograms starting at age 40.
Talk to your doctor about your personal risk of breast cancer and the screening routine that makes sense for you. That may include getting a breast cancer risk assessment in your 30s.
The American Academy of Ophthalmology recommends getting a baseline eye exam when you turn 40 to check for early signs of disease or vision changes. Presbyopia, or age-related farsightedness, usually starts in your 40s.
After your first eye exam, your doctor can tell you how often to come back for repeat screening.
Once you turn 65, get your eyes checked every year or two to monitor for eye problems like cataracts, age-related macular degeneration, and glaucoma.
Blood glucose tests
Blood glucose tests can help determine if your body is having trouble processing blood sugar, which can be a sign of pre-diabetes or diabetes. Screening methods include a fasting plasma glucose test and an A1C test.
People ages 40 to 70 who are overweight or obese should have their blood sugar levels checked regularly, according to the USPSTF. The American Diabetes Association recommends that everyone have their blood glucose tested at age 45 and then retested at least every three years.
In your 50s
Hepatitis C test
Baby Boomers are at higher risk of infection with the hepatitis C virus and, for that reason, the USPSTF recommends that all adults born between 1945 and 1965 be screened at least once.
“The Baby Boomers should be screened for hepatitis C whether or not they are symptomatic,” says Dr. Ramas, a former board member of the American Academy of Family Practitioners. “We have great treatments with high success rates and low side effect [rates].”
Colorectal cancer screening
Current USPSTF guidelines recommend that people at average risk for colorectal cancer start screening at age 50 and stop at age 75.
In 2018, the American Cancer Society issued new guidelines recommending regular colorectal cancer screening starting at age 45 rather than 50. The Society’s reasoning was that colon cancer was striking younger and younger. No other organizations have changed their recommendations yet, but that may be because they “haven’t had a chance to review it,” says Dr. Bevers.
Whenever you start, the timing of repeat screening varies after your first test. “The frequency is going to be determined on the risk depending on precancerous polyps,” says Dr. Bevers. If no polyps are found after a colonoscopy, for example, you can typically wait 10 years before having another. Other testing methods require more frequent screening.
Talk to your doctor about the best colorectal cancer test for you and how often to repeat it.
Lung cancer screening
The USPSTF now recommends screening for lung cancer with low-dose computed tomography for adults ages 55 to 80 who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.
A pack-year is a way of measuring how much someone has smoked in the past. One pack-year equals an average of one pack of cigarettes a day for a year. A 30 pack-year history, then, is a pack a day for 30 years; two packs a day for 15 years; or three packs a day for 10 years, for example.
Other organizations have issued similar recommendations, although the American Cancer Society guidelines only go up to age 74.
Even though up to 40% of adults over the age of 50 have some degree of hearing loss, there are no formal recommendations for routine hearing tests from the USPSTF.
However, “routine hearing screenings may reduce the prevalence of under-diagnosed and under-treated hearing loss in adults,” according to the American Speech-Language-Hearing Association.
If you suspect you aren’t hearing as well as you used to, ask your primary care doctor or a hearing specialist about a screening.
In your 60s
Although the USPSTF does not recommend routine thyroid screening, some organizations do suggest considering it after age 60. Talk to your doctor to see if this is for you.
Your doctor may recommend having your thyroid hormone levels checked at a younger age if you have symptoms like fatigue, unexplained weight gain, or period changes.
Bone measurement test
Bone measurement tests screen for osteoporosis. They can tell you if you have the bone condition or are at risk for developing it. The most common is dual-energy x-ray absorptiometry or DXA, which measures bone density.
The USPSTF suggests osteoporosis screening for all women aged 65 or older. If you have risk factors, such as long-term steroid use, you may want to get one earlier.