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Definition

You should visit your health care provider from time to time, even if you are healthy. The purpose of these visits is to:

• Screen for medical issues
• Assess your risk for future medical problems
• Encourage a healthy lifestyle
• Update vaccinations and other preventive care services
• Help you get to know your provider in case of an illness

Information

Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.

There are specific times when you should see your provider or receive specific health screenings. The US Preventive Services Task Force publishes a list of recommended screenings. Below are screening guidelines for women ages 18 to 39.

BLOOD PRESSURE SCREENING

Your blood pressure should be checked at every 3 to 5 years.

Ask your provider if you need your blood pressure checked more often if:

• You have diabetes, heart disease, kidney problems, are overweight, or have certain other health conditions.
• You have a first-degree relative with high blood pressure.
• You are Black.
• Your blood pressure top number is from 120 to 129 mm Hg, or the bottom number is from 70 to 79 mm Hg.
  
• You had high blood pressure during a pregnancy.

If the top number is 130 mm Hg or greater, but lower than 140 mm Hg or the bottom number is 80 mm Hg or greater but lower than 90 mm Hg, this is considered stage 1 hypertension. Readings above these are considered stage 2 hypertension. Schedule an appointment with your provider to learn how you can reduce your blood pressure. Record your blood pressure numbers and bring this information to share with your provider.

Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.

BREAST CANCER SCREENING

• Experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.
• A screening mammogram is not recommended for most women under age 40.

Your provider may discuss and recommend mammograms, MRI scans, or ultrasounds if you have an increased risk for breast cancer, such as:

• A mother or sister who had breast cancer at a young age (most often starting screening earlier than the age the close relative was diagnosed).
• You carry a high-risk genetic marker.

CERVICAL CANCER SCREENING

Cervical cancer screening should start at age 21 years unless your provider advises otherwise.

After the first test:

• Women ages 21 through 29 should have a Pap test every 3 years. Experts do not agree on whether HPV testing is recommended for this age group.
• Women ages 30 through 65 should be screened with either a Pap test every 3 years or the HPV test every 5 years or both tests every 5 years (called "cotesting").
• Women who have been treated for precancer (cervical dysplasia) should continue to have Pap tests for 20 years after treatment or until age 65, whichever is longer.

If you have had your uterus and cervix removed (total hysterectomy), and you have not been diagnosed with cervical cancer or precancer (high grade cervical neoplasia), you do not need cervical cancer screening.

CHOLESTEROL SCREENING

Cholesterol screening should begin at:

• Age 45 for women with no known risk factors for coronary heart disease
• Age 20 for women with known risk factors for coronary heart disease

Repeat cholesterol screening should take place:

• Every 5 years for women with normal cholesterol levels.
• More often if changes occur in lifestyle (including weight gain and diet).
• More often if you have diabetes, heart disease, kidney problems, stroke, or other blood flow problems in the legs or feet, or certain other conditions.
• Your provider may recommend testing more often if you are taking medicines to control high cholesterol.

DENTAL EXAM

• Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you need more frequent visits.

PREDIABETES AND TYPE 2 DIABETES SCREENING

You should be screened for prediabetes diabetes and type 2 diabetes starting at age 35. Screening should be repeated every 3 years if you are overweight or have obesity.

Screening may need to start earlier and be repeated more often if you have other risk factors for diabetes, such as:

• You have a first-degree relative with diabetes.
• You have high blood pressure, prediabetes, or a history of heart disease.

Screening for diabetes should be done if you are planning to become pregnant and you are overweight and have other risk factors such as high blood pressure.

EYE EXAM

• Have an eye exam every 5 to 10 years before age 40.
• If you have vision problems, have an eye exam every 2 years or more often if recommended by your provider.
• You should have an eye exam that includes an examination of your retina (back of your eye) at least every year if you have diabetes.

IMMUNIZATIONS

Commonly needed vaccines include:

• Flu shot: get one every year.
• COVID-19 vaccine: ask your provider what is best for you.
• Tetanus-diphtheria and acellular pertussis (Tdap) vaccine: have one at or after age 19 as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent.
• Tetanus-diphtheria: have a booster (Td or Tdap) every 10 years.
• Varicella vaccine: receive 2 doses if you never had chickenpox or the varicella vaccine.
• Hepatitis B vaccine: receive 2, 3, or 4 doses, depending on your exact circumstances.
• Measles, mumps, and rubella (MMR) vaccine: receive 1 to 2 doses if you are not already immune to MMR. Your provider can tell you if you are immune.

Ask your provider about the human papillomavirus (HPV) vaccine if:

• You have not received the HPV vaccine in the past.
• You have not completed the full vaccine series (you should catch up on this shot).

Ask your provider if you should receive other immunizations if you have certain health problems that increase your risk for some diseases such as pneumonia.

INFECTIOUS DISEASE SCREENING

• Women who are sexually active should be screened for chlamydia and gonorrhea up until age 25.
• Women 25 years and older should be screened for chlamydia and gonorrhea if at high risk.

Screening for hepatitis C:

• All adults ages 18 to 79 should get a one-time test for hepatitis C.
• Pregnant people should be screened at every pregnancy.

Screening for human immunodeficiency virus (HIV):

• All people ages 15 to 65 should get a one-time test for HIV.

Depending on your lifestyle and medical history, you may also need to be screened for infections such as syphilis and HIV, as well as other infections.

PHYSICAL EXAM

All adults should visit their provider from time to time, even if they are healthy. The purpose of these visits is to:

• Screen for disease.
• Assess your risk of future medical problems.
• Encourage a healthy lifestyle.
• Update your vaccinations and other preventive care services.
• Maintain a relationship with a provider in case of an illness.

Your height, weight, and BMI should be checked at every exam.

During your exam, your provider may ask you about:

• Depression and anxiety
• Diet and exercise
• Alcohol and tobacco use
• Safety issues, such as using seat belts, smoke detectors, and intimate partner violence
• Your medicines and risk for interactions

SKIN SELF-EXAM

Your provider may check your skin for signs of skin cancer, especially if you're at high risk, such as if you:

• Have had skin cancer before
• Have close relatives with skin cancer
• Have a weakened immune system

OTHER SCREENING

• Talk with your provider about colon cancer screening if you have a strong family history of colon cancer or polyps, or if you have had inflammatory bowel disease or polyps yourself.
• Routine bone density screening of women under 40 is not recommended.

References

American Academy of Ophthalmology website. Clinical statement: comprehensive adult medical eye examination PPP 2020. www.aao.org/education/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation-ppp. Updated November 2020. Accessed May 21, 2024.

American Cancer Society website. Breast cancer early detection and diagnosis: American Cancer Society recommendations for the early detection of breast cancer. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Updated December 19, 2023. Accessed May 21, 2024.

American College of Obstetricians and Gynecologists (ACOG) website. FAQ178: Mammography and other screening tests for breast problems. www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems. Updated July 2022. Accessed May 21, 2024.

American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated October 2023. Accessed May 21, 2024.

American Dental Association website. Your top 9 questions about going to the dentist -- answered! www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed May 21, 2024.

American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S20-S42. PMID: 38078589; PMCID: PMC10725812. pubmed.ncbi.nlm.nih.gov/38078589/.

Barton MB, Wolff TA. The preventive health visit. In: Goldman L, Cooney K, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 12.

Brown HL, Warner JJ, Gianos E, et al; American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843-e852. PMID: 29748185 pubmed.ncbi.nlm.nih.gov/29748185/.

Centers for Disease Control and Prevention website. Recommended Vaccinations for Adults. Recommended Immunizations for adults aged 19 years and older, United States, 2024. www.cdc.gov/vaccines/imz-schedules/adult-easyread.html. Updated August 14, 2024. Accessed September 26, 2024. 

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2019;73(24):3237-3241]. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/30423393/.

Meschia JF, Bushnell C, Boden-Albala B; American Heart Association Stroke Council; et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated March 28, 2024. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: medication use to reduce risk. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-medications-for-risk-reduction. Updated September 3, 2019. Accessed May 21, 2024.

US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2024 Apr 30. Epub ahead of print. PMID: 38687503. pubmed.ncbi.nlm.nih.gov/38687503/.

US Preventive Services Task Force website. Final recommendation statement. Cervical cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Updated August 21, 2018. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Updated May 18, 2021. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement. Hepatitis C virus infection in adolescents and adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Published March 2, 2020. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement. Human immunodeficiency virus (HIV) infection: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Published June 11, 2019. Accessed May 21, 2024.

US Preventive Services Task Force website. Hypertension in adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening. Published April 27, 2021. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement: Lung cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Updated March 9, 2021. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement. Prediabetes and type 2 diabetes: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes. Updated August 24, 2021. Accessed May 21, 2024.

US Preventive Services Task Force website. Final recommendation statement. Skin cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/skin-cancer-screening. Updated April 18, 2023. Accessed May 21, 2024.

Whelton PK, Carey RM, Mancia G, Kreutz R, Bundy JD, Williams B. Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines: Comparisons, reflections, and recommendations. Circulation. 2022;146:868-877. DOI: 10.1161/CIRCULATIONAHA.121.054602. PMID 35950927. pubmed.ncbi.nlm.nih.gov/35950927/.

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