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      COVID-2019 Alert

      Information about the 2019 Novel Coronavirus. Read the latest >

      Información sobre el coronavirus 2019 (COVID-19). Aprenda más >

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      Prevention Guidelines for Women 65+

      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.

      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

      Every two years if your blood pressure reading is less than 120/80 mm Hg1

      Yearly if your systolic blood pressure reading is 120 to 139 mm Hg or your diastolic blood pressure reading is 80 to 89 mm Hg1

      Breast cancer

      All women2

      Yearly mammogram and clinical breast exam2

      Cervical cancer

      According to the American Cancer Society (ACS), women older than 65 who have had regular screening with normal results should not be screened for cervical cancer. Once screening is stopped, it should not be started again.

      Discuss with your healthcare provider3

      Chlamydia

      Women at increased risk for infection

      At routine exams if at risk

      Colorectal cancer

      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:

      • Flexible sigmoidoscopy every 5 years4, or

      • Colonoscopy every 10 years, or

      • CT colonography (virtual colonoscopy) every 5 years4

      For tests that primarily find cancer:

      • Yearly fecal occult blood test5, or

      • Yearly fecal immunochemical test every year5, or

      • Stool DNA test, every 3 years5

      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.

      Depression

      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

      At routine exams

      Gonorrhea

      Sexually active women who are at increased risk for infection

      At routine exams if at risk

      HIV

      Anyone 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

      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 provider6

      Lung cancer

      Adults age 55 to 80 who have smoked

      Yearly screening in smokers with 30 pack per year history of smoking or who quit within 15 years

      Obesity

      All adults

      At routine exams

      Osteoporosis, postmenopausal

      All women ages 65 and older7

      Bone density test at age 65, then follow-up as recommended by healthcare provider7

      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 adults8

      Every 1 to 2 years; if you have a chronic disease, check with your healthcare provider for exam frequency

      Counseling

      Who needs it

      How often

      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

      Discuss with your healthcare provider

      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

      At routine exams

      Sexually transmitted diseases prevention

      All women at increased risk

      At routine exams

      Tobacco use and tobacco-related disease

      All adults

      Every exam

      Immunization

      Who needs it

      How often

      Tetanus/diphtheria/
      pertussis (Td/Tdap) booster

      All adults

      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.

      Chickenpox (varicella)

      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

      Flu (seasonal)

      All adults

      Yearly, when the vaccine becomes available in the community

      Hepatitis A vaccine

      People at risk9

      Two doses given 6 months apart

      Hepatitis B vaccine

      People at risk10

      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

      Zoster

      All women ages 60 and older

      One dose

      1Recommendation from the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure

      2American Cancer Society

      3The American Congress of Obstetricians and Gynecologists currently recommends that women ages 30 and older get a Pap test once every three years and that women with certain risk factors (or with increased risk) may need more frequent screening. It's reasonable to discontinue screening after three or more consecutive negative Pap tests and no abnormal results within the last 10 years once a woman turns 65 or 70.

      4If the test is positive, a colonoscopy should be done

      5The 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.

      6Recommendation from ACOG

      7Recommendation by the USPSTF

      8Recommendation from the American Academy of Ophthalmology

      *Exceptions may exist; discuss with your healthcare provider

      Other guidelines from the USPSTF

      Immunization schedule from the CDC

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      • Multiple Sclerosis (MS)
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