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Eating a balanced diet, exercising regularly and managing stress are all great ways to take charge of your health. But those steps aren’t enough. Staying on top of routine health screenings should also be part of the picture—diseases and worrisome medical conditions are usually most treatable when detected early.
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However, research reports that only 8% of U.S. adults ages 35 and older receive all the appropriate preventive services, including recommended screenings and vaccinations[1].
Read on to find out which health screenings women should have, why and how often.
Women’s Health Screenings and Tests
Depending on a woman’s age and stage of life, certain health screenings and tests are recommended to identify the presence of various medical conditions or early signs that they’re developing. While there are general guidelines for which tests to have and when, you may need to get screened sooner or more often than what’s generally recommended, depending on your personal and family medical histories.
“Coming up with a [universal] proper age for a screening test is really hard because you have to factor in costs and personal risk factors,” says Heather Hirsch, M.D., clinical program director of the Menopause & Midlife Clinic at the Brigham and Women’s Hospital in Boston.
Many of these tests can be performed in your doctor’s office while others require a visit to a radiology center.
Blood Pressure Test
Why it’s important: High blood pressure (hypertension) can significantly increase your risk of developing heart disease, stroke, dementia, kidney problems, vision problems and sexual dysfunction. It’s dubbed the “silent killer” because there typically aren’t any obvious symptoms that signal something is wrong.
What it is: A blood pressure test involves the use of an instrument called a sphygmomanometer in your doctor’s office. It has a cuff that inflates with air, a meter that measures air pressure in the cuff, and a stethoscope that allows your doctor to listen to the sound the blood makes as it flows through the major artery found in your upper arm. You can also buy a blood pressure monitor for home use, but note that not all blood pressure monitors are created equal—and some may not offer accurate readings under certain circumstances. Be sure to check with your doctor about brands and types they recommend, and directions on how to get an accurate reading.
How often you should get it: Everyone ages 18 and older without known hypertension should have their blood pressure measured, but how often depends on your blood pressure. If it’s below 120/80 mmHg, which is considered the upper limit of normal, the American Heart Association recommends having it checked at least once every two years starting at age 20, while the U.S. Preventive Services Task Force (USPSTF) recommends screening every three to five years for low-risk people, ages 18 to 39. Meanwhile, the USPSTF recommends an annual screening for high-risk individuals and those ages 40 and older. If your blood pressure is higher or you’re being treated for high blood pressure, your doctor may want to check it more frequently.
Lipid Panel
Why it’s important: If you have too much cholesterol, a waxy-like substance found in all cells of your body, it can build up with other substances in your blood and form plaque, increasing your risk for heart disease and stroke. Like hypertension, high cholesterol typically has no signs or symptoms.
What it is: A lipid panel, sometimes called a cholesterol test, requires a blood sample, which is drawn at your doctor’s office or a nearby lab. The sample is then used to evaluate levels of total cholesterol, low-density lipoprotein (LDL, the “bad” cholesterol), high-density lipoprotein (HDL, the “good” cholesterol) and triglycerides in your blood. You may be advised to avoid eating or drinking anything (other than water) for eight to 12 hours before the test.
How often you should get it: Young adults between the ages of 17 and 21 should have their cholesterol checked, and most experts agree on a cadence of every five years. However, shorter screening intervals are often recommended for people with abnormal lipid levels, those on certain medications and high-risk individuals—which typically includes people with diabetes, those with a personal history of heart disease or a family history of cardiovascular disease, people who use tobacco, people who have hypertension and people with obesity.
Screening for Diabetes and Pre-Diabetes
Why it’s important: Diabetes—a medical condition that occurs when your blood sugar is too high—can affect your health from head to toe, increasing your risk of vision problems, cardiovascular disease and stroke, high blood pressure, kidney disease, neuropathy (nerve damage) and skin and foot problems. Approximately 1 in 3 people have pre-diabetes[2].
What it is: A diabetes test requires a blood sample, which is drawn at your doctor’s office or a lab. You can have a blood sugar test taken at any time without fasting, but other types of diabetes tests include:
- A1C test: This blood test measures your average blood sugar levels over the past three months.
- Fasting blood sugar test: Your blood sugar is measured after an overnight fast, which consists of not eating or drinking anything but water since the previous night.
- Glucose tolerance test: This test measures your blood sugar before and after you drink a drink containing glucose. You fast before this test and then, after drinking the glucose drink, you have your blood sugar tested again at certain intervals. Note that this test is rarely used, with the exception of pregnant people when screening for gestational diabetes.
How often you should get it: The USPSTF currently recommends adults between the ages of 35 and 70 who are overweight or obese be tested for diabetes every three years. Note that the National Institute of Diabetes and Digestive and Kidney Diseases, though, recommends routine testing for those between the ages of 19 and 40 who are overweight, obese or have other diabetes risk factors. Be sure to talk to your doctor about when—and how often—you should get tested.
Cervical Cancer Screening
Why it’s important: Cervical cancer used to be one of the most common causes of cancer-related deaths among women in the U.S. Rates have decreased, though, thanks to the widespread use of the Pap test, which can detect cellular changes of the cervix before they become cancerous. Additionally, the human papillomavirus (HPV) vaccine helps protect against HPV infections most commonly linked to cervical cancer.
“The HPV vaccine is so effective at decreasing the risk of HPV and cervical cancer,” says Dr. Hirsch. “And cervical cancer is so preventable with regular screenings.” If abnormal cells are found on the cervix during a screening, they can be removed at a later date.
What it is: With the Pap test (commonly referred to as a Pap smear), a healthcare professional places a speculum inside the vagina, lightly scrapes cells from the woman’s cervix and sends them to a lab to look for precancerous changes. With the HPV test, healthcare professionals look for the high-risk types of HPV, the primary cause of cervical cancer, in a sample of cells from the cervix. Both tests can be conducted at the same time.
How often you should get it: You should start getting cervical cancer screenings at age 21. If the results are normal, you may be able to wait three years until your next one and stick with that interval until you’re 29. Between the ages of 30 and 65, you can have a combination of the Pap and HPV tests—an approach called co-testing—every five years if your results are consistently normal. You can also have a Pap test every three years—assuming the results are normal—or you can have an HPV test every five years, if the results are normal. After age 65, there’s generally no need for further testing in women of average risk (that have had adequate prior testing with negative results) for cervical cancer.
Breast Cancer Screening
Why it’s important: After skin cancer, breast cancer is the most common cancer among women in the U.S.[3] Having regular mammograms is the best way for doctors to find breast cancer early (when it’s most treatable) and often years before it can be felt.
What it is: A mammogram is an X-ray of your breast tissue. Two special plates on the machine flatten the breast, holding it in place while the X-ray is taken. Mammograms can be performed at a radiology or imaging center or at a hospital.
How often you should get it: There isn’t a consensus on how often you should get a mammogram. The American Cancer Society advises women to start getting mammograms every year between the ages of 45 and 54 and then every two years after age 55. Meanwhile, the USPSTF recommends women have mammograms every other year between the ages of 50 and 74, while the American College of Obstetricians and Gynecologists recommends women start receiving mammograms every one to two years, beginning at age 40 to 50, up until age 75.
All of these recommendations assume the results of the mammograms are normal and that the woman is at average risk for breast cancer. Given the disparity in recommendations, “the best thing is to engage in shared decision-making with your doctor,” says Dr. Hirsch. Your doctor may also recommend different screening intervals based on your own, personal risk factors.
Bone Density Screening
Why it’s important: Bone density screenings check for osteoporosis, a disease that occurs when the body loses too much bone, makes too little of it or both. These screenings can estimate your risk of breaking a bone before it happens.
What it is: Typically, a central DXA machine—a type of X-ray scanner—measures bone density in the hips and spine, partly because people with osteoporosis have an increased risk of fracturing these bones. What’s more, bone density in these areas can predict the risk of future breaks in other bones. Private radiology groups, hospital radiology departments and some medical practices offer this test.
How often you should get it: The USPSTF recommends women ages 65 and older be screened for osteoporosis, as well as younger women who are at increased risk—either because they regularly take certain medications that compromise bone density, have a parent who fractured a hip, smoke, consume excessive alcohol or have low body weight. There is limited evidence, though, that repeated screenings are beneficial in predicting bone fractures four and eight years after the initial screening, according to the taskforce.
However, not all physicians agree with these guidelines. Dr. Hirsch, for example, recommends having a baseline bone density test two to three years after menopause.
“We lose the vast majority of bone when we lose estrogen, which happens when we go through menopause,” she says. “So I think that’s the right time to check. We don’t put enough emphasis on osteopenia [a condition involving low bone mass]—we could monitor and treat it just like we do with pre-diabetes and prevent it from progressing.”
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Colorectal Cancer Screening
Why it’s important: Colorectal cancer is the third most common cancer and the third leading cause of cancer-related deaths in the U.S.[4] “When it’s caught early, it’s very treatable,” says Dr. Hirsch, adding that it’s even preventable if polyps (abnormal tissue growth) are removed before they have a chance to become cancerous.
What it is: There are several screening tests for colorectal cancer:
- Stool tests: These tests include a guaiac-based fecal occult blood test (gFOBT), which relies on a chemical to detect blood in the stool (done annually); the fecal immunochemical test (FIT), which uses antibodies to detect blood in the stool (done annually); and the FIT-DNA test, which looks for altered DNA in the stool, in addition to blood in the stool (done every three years). With all of these tests, you collect a stool sample at home and send it to a lab for analysis.
- Flexible sigmoidoscopy: A doctor places a short, thin, flexible and illuminated tube into your rectum to check for polyps and cancerous growths inside the rectum and lower part of the colon. This is typically performed every five years with an annual FOBT test, or every 10 years with a FIT test every year.
- Computed tomography (CT) colonography (or a virtual colonoscopy): A doctor uses X-rays and computers to create images of the entire colon for evaluation. This is performed every five years.
- Colonoscopy: A doctor uses a thin, flexible, lighted tube to look for polyps and cancerous growths inside the rectum and the entire colon. During the procedure, the doctor can remove polyps or other growths they may find. This is typically performed every 10 years, assuming normal results for individuals who do not have an increased risk of colon cancer.
How often you should get it: The latest recommendations call for adults between the ages of 45 and 75 to be screened for colorectal cancer. After 75, screening decisions should be made on an individual basis. How often you should get tested varies based on the type of test you receive, and can range from every year to every 10 years. Depending on the results and the type of test used, the recommended follow-up frequency varies. If colorectal cancer runs in your family or you have other risk factors, you may be advised to be screened at a younger age or more frequently. Talk to your doctor about how often you should get tested, taking into consideration factors such as the test’s effectiveness, cost and availability of screenings.
The screening tests mentioned in this article are critical—but aren’t comprehensive. Other important screening tests to prioritize can include STI screenings, BMI tests, mental health screenings and more. Screening tests, and their intervals, will vary based on your risk factors, and certain individuals might benefit from additional tests that can screen for everything from skin cancer to iron deficiencies.
Talk to your doctor about what types of preventive screenings should be part of your healthcare routine—it’s an important and crucial step in taking control of your health.
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