What screening tests do I need as a 60-year-old woman?

DEAR DOCTOR K:

I’m a healthy, 60-year-old woman. What screening tests do I need, and how often?

DEAR READER:

Too many people wait until something is wrong before visiting their doctor. Keeping up with screening tests can help you identify and nip a problem in the bud.

I’ll give you the general guidelines for a woman your age as laid out by the U.S. Department of Health and Human Services. As you’ll notice, the frequency of some tests is left up to your doctor. How often you have these tests should be based on your personal and family medical history.

  • General exam: Discuss with your doctor. There actually is not much evidence that a complete physical examination each year is worth doing. Yet I still do it, and my patients still expect me to do it.
  • Blood pressure measurement: at least every two years. This one is a no-brainer: Undiagnosed and untreated high blood pressure may be the biggest threat we have to our health. And the problem is, you don’t know if your blood pressure is high just from symptoms. You have to measure it.
  • Cholesterol test: Discuss with clinician; many groups recommend every five years.
  • Bone density screening: at least once in women age 65 or older, or at a younger age if you have a relatively higher risk for osteoporosis. You can determine your risk online by using a FRAX calculator. The original calculator can be found at http://shef.ac.uk/FRAX.
  • Blood glucose test: every three years.
  • Mammogram: every one to two years.
  • Pap smear: every one to three years, if your uterus and cervix have not been surgically removed.
  • Pelvic exam: every one to three years.
  • HIV test: at least once to find out your status, if you have any risk factors for HIV.
  • Sexually transmitted infection (STI) tests: before initiating intercourse with a new partner.
  • Mental health screening: discuss with clinician.
  • Colorectal health:
    • Fecal occult blood test: yearly OR
    • Flexible sigmoidoscopy: every five years OR
    • Colonoscopy: every 10 years.
  • Complete eye exam: every two to four years, or as advised by clinician.
  • Hearing test: every three years.
  • Mole exam: clinical exam or physical; self-exam monthly.
  • Dental exam: routinely; discuss with dentist.

Finally, pay attention to your body. Keep an eye on new spots and bumps. Note changes in your regular patterns, be they in appetite, sleep, mood, energy or bowel habits.

We have more information on staying healthy as you age in our Special Health Report, “A Guide to Women’s Health: Fifty and Forward.” You can learn more about it here.

Screening guidelines change once you hit age 65, so revisit this topic with your doctor in a few years.