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. In addition, major organizations may vary in recommendations on these prevention guidelines.

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All adults starting 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 use or misuse

All adults

At routine exams

Blood pressure

All adults

Every year if your blood pressure reading is less than 120/80 mm Hg

If your blood pressure reading is higher than normal, follow the advice of your healthcare provider

Breast cancer

All women

Mammogram every other year or you may choose to continue mammograms every year

Cervical cancer

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

Discuss with your healthcare provider

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:

  • Colonoscopy every 10 years (recommended), or

  • Flexible sigmoidoscopy every 5 years, or

  • CT colonography (virtual colonoscopy) every 5 years

For tests that primarily find cancer:

  • Yearly fecal occult blood test or

  • Yearly fecal immunochemical test every year, or

  • Stool fecal immunochemical test plus DNA test, every 3 years

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 provider

Lung cancer

Adults age 55 to 74 who in fairly good health and are at higher risk for lung cancer defined as current smokers or persons who have quit within past 15 years, and have a 30-pack-year smoking history (Eligibility criteria may vary across major organizations; Age limit may extend to age 80.)

Talk with your healthcare provider for more information.

Yearly lung cancer screening with a low-dose CT scan (LDCT)

Obesity

All adults

At routine exams

Osteoporosis, postmenopausal

All women ages 65 and older

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

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 adults

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

Vaccines

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 risk

Two doses given 6 months apart

Hepatitis B vaccine

People at risk

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

Recombinant zoster vaccine (RZV)

All women ages 50 and older

2 doses; the 2nd dose is given 2 to 6 months after the first. This is given even if you've had shingles before or had a previous zoster live vaccine. 

Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Maryann Foley RN BSN
Online Medical Reviewer: Robert Hurd MD
Date Last Reviewed: 1/1/2021
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