Prevention Guidelines for Women 50 to 64

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Here are the screening tests and immunizations that most women ages 50 to 64 need. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening	Who needs it	How often
Type 2 diabetes or prediabetes	All adults beginning 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	Guidelines recommend the following screening schedules: Every 2 years if your blood pressure reading is less than 120/80 mm Hg, or Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg
Breast cancer	All women*	Yearly mammogram should be done until age 54. At age 55switch to mammograms every other year or may choose to continue yearly mammograms.* Our system has a more stringent recommendation. Please see our SCL Health mammography screening guidelines.
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
Chlamydia	Women at increased risk for infection	At routine exams
Colorectal cancer	All adults starting at age 50	According to the American Cancer Society (ACS): For tests that find polyps and cancer: Flexible sigmoidoscopy every 5 years¹, or Colonoscopy every 10 years, or Double-contrast barium enema every 5 years¹ For tests that primarily find cancer: Yearly fecal occult blood test², or Yearly fecal immunochemical test every year², or Stool DNA test, every 3 years The tests that are designed to find both early cancer and polyps are preferred if these tests are available to you and you are willing to have one of these more invasive tests. Talk with your doctor about which test 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 increased risk for infection	At routine exams if at risk
Hepatitis C	Anyone at increased 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 increased risk for coronary artery disease	At least every 5 years
Obesity	All adults	At routine exams
Lung cancer	Adults age 55 to 80 who have smoked	Yearly screening in smokers with 30 pack year history of smoking or who quits within 15 years
Osteoporosis, postmenopausal women	Women at age 60 who are at increased risk for fractures caused by osteoporosis	Check with your health care provider
Syphilis	Anyone at increased risk for infection	At routine exams if at risk
Tuberculosis	Anyone at increased risk for infection	Check with your healthcare provider
Vision	All adults³	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; discuss 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 increased risk	When risk is identified
Diet and exercise	Women who are overweight or obese	When diagnosed
Tobacco use and tobacco-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 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**	Two 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 risk⁴	Two doses given at least 6 months apart
Hepatitis B vaccine	High risk adults	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)
Meningococcal	People at risk**	One or more doses
Pneumococcal (PCV13) Pneumococcal (PPSV23)	People at risk⁶	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)
Zoster	All women ages 60 and older**	One dose

*American Cancer Society

**Exceptions may exist, please check with your healthcare provider

¹If the test is positive, a colonoscopy should be done

²The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

³Recommendation from the American Academy of Ophthalmology

⁴For complete list, see the CDC website

⁵For complete list, see the CDC website

⁶For complete list, see the CDC website

Other guidelines are from the USPSTF

Immunization schedule from the CDC

Online Medical Reviewer: Cunningham, Louise, RN
Online Medical Reviewer: Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
Online Medical Reviewer: Stump-Sutliff, Kim, RN, MSN, AOCNS
Online Medical Reviewer: Turley, Ray, BSN, MSN

Date Last Reviewed: 11/5/2015

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