Screening Guidelines for Women of All Ages

Periodic health screenings can help you and your health care professional identify health problems early, when treatment may be most successful. See the list below for specific screening recommendations, including when and how often you should have the screening and what the screening is designed to do. Ask your health care professional about other health screenings that may also be good for your health.

Breast self-exam:

Begin at age 20 and continue once a month. Examining your breasts regularly allows you to be aware of what feels normal and what doesn't. Any unusual breast symptoms or change in breast tissue such as swelling, dimpling, nipple discharge, persistent pain, redness, unusual masses or any other variation in how breasts look and feel should be reported immediately to your health care professional. A mammogram and breast exam by a trained health care professional (called a clinical breast exam) are the most reliable methods for finding breast cancer in its earliest, most treatable stages (see below).


Clinical breast exam by a trained health care professional:

Should begin at age 20 and be repeated every three years until age 40; continue annually if you are over the age of 40. Ideally, the clinical breast exam should be done before the scheduled mammogram. During a clinical breast exam, a health care professional should visually examine as well as carefully feel your breasts for anything abnormal, such as swelling, dimpling, nipple discharge, persistent pain, redness, unusual masses and any other variation in how breasts look and feel.


Beginning at age 40, have a mammogram once every one to two years. A mammogram produces images of the inner breast tissue (of each breast) on film, using a very low dose of radiation produced by a machine specifically designed for mammograms. Mammogram can help identify cysts, calcifications and tumors within the breast. It is currently the most effective way to detect early breast cancer.

Pelvic exam, including a Pap smear test:

Begin at age 18 or at the onset of sexual activity, if earlier, and continue annually. After three or more consecutive satisfactory normal annual exams, the Pap test may be performed less frequently at the discretion of your health care professional. During a pelvic exam, your health care professional looks at your pelvic area, internally and externally, for anything abnormal. The Pap smear test is a simple, quick procedure during which your health care professional uses a small swab to gently scrape the inside of your cervix to obtain cells for the Pap smear. The cells are prepared on a cell and sent to a laboratory where they will be inspected for signs of cancerous and pre-cancerous changes.

Colon cancer screening:

Begin at age 50 and continue once a year. If you have a family history of colon cancer or polyps (small growths in the colon that are a risk factor colon cancer) you should begin having regular screenings at a younger age; ask your health care professional for guidance. A simple test called a fecal occult blood, which checks for blood in your stool (a symptom of colon cancer) is typically used every year to screen for abnormalities that may be colon cancer. Additionally, adults over age 50 should have a flexible sigmoidoscopy every five years, a procedure that uses a thin flexible lighted tube to examine the rectum and lower colon. A colonoscopy may be recommended every 10 years as an alternative. This procedure examines the entire colon. Individuals with a family history of colon cancer or polyps should ask their health care professionals how often they should be screened and what additional screening options may be recommended.

Blood cholesterol screening:

Testing for blood cholesterol should begin at age 20 and be repeated every five years or at a frequency recommended by your health care professional. This screening determines if you have high blood cholesterol, which can lead to heart disease. A fasting lipoprotein profile is the most accurate type of cholesterol screening; it measures HDL and LDL cholesterol and triglyceride levels.

Blood pressure reading:

Women age 21 and older should have their blood pressure measured. This simple screening checks for high blood pressure, which can lead to heart disease.

Bone mineral density exam/bone mass measurement: Bone density screenings assess your bone mass, or density, and help to identify low bone density, which can lead to fractures and osteoporosis. According to American Association of Clinical Endocrinologists guidelines, the Bone Mineral Density (BMD) test is recommended for all women 40 years old or older who have sustained a fracture, and for all women beyond 65 years of age. The test is also recommended for women who are at increased risk due to certain medications, and for patients with diseases or nutritional conditions that are known to be associated with bone loss.

Sexually transmitted disease (STD) screening:

Because some STDs do not cause symptoms, it's important to be tested for STDs, if you are sexually active — even if you don't have symptoms. Sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, genital herpes, and HIV can be diagnosed by STD screenings. These screening tests are often performed during your annual gynecologic exam.

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)