Preventive Care Recommendations For quick reference, this snapshot provides a general list of preventive care recommendations that you and your family members may need to consider. It also describes what you can expect during each screening, vaccine or test. Talk to your doctor or other healthcare provider to determine which services you and your family members may need based on your current health, health histories and existing health risks. Note that not all possible preventive services are shown, and the needs of individuals with special conditions and high-risk populations (for example, pregnant women and those with chronic conditions) are not specifically addressed. Years of Age Screening 0-2 3-17 18-19 20-29 30-39 40-49 50-59 60-69+ 1. Well-baby visit At birth; then at one, two, four, six, nine, 12, 15, 18, 24 and 30 months of age. 2. Well-child visit Yearly, ages three through 17. 3. Full checkup Starting at age 18; discuss frequency with your healthcare provider. 4. Blood pressure test Every two years starting at age 18. 5. Cholesterol test Starting at age 20; discuss frequency with your healthcare provider. 6. Blood sugar test Ages 18 through 44; discuss frequency with your healthcare provider. Every three years starting at age 45. 7. Chlamydia test Women: Ages 18 through 25; continue after age 25 if you have multiple partners. / Men: Discuss with your healthcare provider. 8. STD tests Starting at age 18; both partners should get tested for STDs, including HIV, before initiating sexual intercourse. 9. Rectal exam Ages 18 through 49; discuss frequency with your healthcare provider. Every five to 10 years with each screening (sigmoidoscopy, double contrast barium enema or colonoscopy) starting at age 50. April 2009 Page 1 of 6
Years of Age Screening 0-2 3-17 18-19 20-29 30-39 40-49 50-59 60-69+ 10. Eye Exam - Women: Ages 18 through 39; at least once between ages 20 and 29 and at least twice between ages 30 and 39. / Men: Have your eyes checked if you have problems or visual changes. - For both women and men, every two to four years between ages 40 and 64, then every one to two years starting at age 65. 11. Hearing test Ages 18 through 49; start at age 18, then every 10 years. Age 50 and older, discuss with your healthcare provider. 12. Mole exam Ages 20 through 39; monthly self-exam and by a doctor every three years. Starting at age 40, monthly self-exam and yearly doctor exam by a doctor. 13. Dental exam One to two times a year starting at age 18. 14. Mental health screen Starting at age 18; discuss frequency with your healthcare provider. 15. Fecal occult blood test Yearly, starting at age 50. 16. Flexible sigmoidoscopy Every five years (if not having a colonoscopy) starting at age 50. 17. Barium enema Every five to 10 years (if not having a colonoscopy or sigmoidoscopy) starting at age 50. 18. Colonoscopy Every 10 years starting at age 50. 19. Influenza vaccine Yearly, starting at age 50. 20. Tetanus booster Every 10 years starting at age 18. 21. Pneumococcal vaccine Starting at age 65; one time only. April 2009 Page 2 of 6
Years of Age Screening 0-2 3-17 18-19 20-29 30-39 40-49 50-59 60-69+ Preventive Care Required for Women Only 22. Thyroid test Starting at age 35, then every five years. 23. Pap test Ages 18 through 21; every one to three years if sexually active. Every one to three years starting at age 21. 24. Pelvic exam Ages 18 through 21; every one to three years if sexually active. Every one to three years starting at age 21. 25. Mammogram Every one to two years starting at age 40. 26. Bone density test At least one starting at age 65; discuss repeat testing with your healthcare provider. 27. Herpes zoster vaccine One time only starting at age 60; discuss with your healthcare provider. 28. HPV vaccine Ages 18 through 26; discuss with your healthcare provider. Preventive Care Required for Men Only 29. Testicular exam Monthly self-exam, and part of a general checkup starting at age 18. 30. Digital rectal exam Starting at age 40; discuss frequency with your healthcare provider. 31. PSA blood test Starting at age 40; discuss frequency with your healthcare provider. April 2009 Page 3 of 6
What Are These Screenings? 1. Well-baby visit: General evaluation of your baby s growth and development to see whether he or she is reaching the milestones for each specific age. 2. Well-child visit: General evaluation of your child s growth and development to see whether he or she is reaching the milestones for each specific age. 3. Full checkup: General physical exam that includes a basic preventive exam of the eyes, ears, nose, throat and lungs; measurement of height, weight and blood pressure; and a basic exam of the nervous, respiratory and circulatory systems. It may also include a complete skin exam, testicular and prostate exam (for men), and clinical breast exam (for women). 4. Blood pressure test: Measures the force applied to the walls of the arteries as the heart pumps blood through the body. High blood pressure (hypertension) increases the risk of heart failure, heart attack, stroke and kidney failure. Low blood pressure (hypotension) may be a sign of such conditions as heart failure, infection, glandular disorders and dehydration. 5. Cholesterol test: Measures the total amount of cholesterol level in your blood. Elevated cholesterol levels are associated with an increased risk for heart disease and stroke. The test breaks down total blood cholesterol into three main components: High-density lipoprotein (HDL) also known as good cholesterol. Unlike other types of cholesterol, a high level of HDL may lower your risk for heart disease and stroke. Low-density lipoprotein (LDL) also known as bad cholesterol. Very low-density lipoprotein (VLDL) which contains very little protein but is used mainly to distribute triglycerides (a type of fat) produced by your liver. 6. Blood sugar test: Used for the early detection of diabetes or hypoglycemia (low blood sugar). It measures the level of glucose, a type of sugar, in your blood. 7. Chlamydia test: Used to determine whether Chlamydia bacteria are present and causing infection. 8. Sexually transmitted disease (STD) tests: Used to determine whether a person is infected with an STD (e.g., HIV, Chlamydia, gonorrhea, syphilis, hepatitis B, herpes simplex virus [HSV]). 9. Digital Rectal exam: Discuss with your healthcare provider. 10. Eye exam: Designed to check many functions of the eye, including your ability to see details at near and far distances, check for gaps or defects in your field of vision, and evaluate your ability to see different colors. 11. Hearing test: Designed to help detect hearing loss, identify its severity and determine its cause. 12. Mole exam: Visual inspection of the moles on your skin to detect precancerous skin changes and skin cancer. 13. Dental exam: Examination of your teeth and gums for signs of tooth decay, gum disease and other health problems. 14. Mental health screening: Designed to provide an overall picture of your emotional state and your ability to think, reason and remember. It can help identify and monitor mental health problems and help distinguish between mental and physical health problems. 15. Fecal occult blood test: Detects the presence of hidden (occult) blood in the stool. It s an effective screening test for colorectal cancer because cancerous tissue and precancerous polyps are more likely to bleed than normal colon tissue. It is also used for detecting ulcers, tumors and other digestive system diseases. April 2009 Page 4 of 6
What Are These Screenings? (continued) 16. Flexible sigmoidoscopy: Outpatient procedure that allows a doctor to examine the inner lining of the lower large intestine for abnormal growths, inflammation, bleeding, hemorrhoids and other conditions. This test can be used to screen for colorectal cancer. 17. Double contrast barium enema: X-ray examination of the large intestine. To make the intestine visible on an X-ray, the colon is filled with a barium-containing contrast material and then emptied, leaving a thin layer of barium on the colon wall. The colon is then filled with air, which provides a detailed view of the inner surface of the colon. This test can be used to screen for colorectal cancer. 18. Colonoscopy: Outpatient procedure that permits the doctor to examine the entire colon. This test is used to screen for colorectal cancer. 19. Influenza vaccine: Immunization to prevent influenza (flu). 20. Tetanus-diphtheria booster vaccine: Helps prevent two bacterial infections: Tetanus, a life-threatening nerve disorder; and Diphtheria, which can cause breathing and swallowing problems, and can damage the heart and central nervous system. 21. Pneumococcal vaccine: Helps prevent infection with Pneumococcus, which can cause several severe infections, including pneumonia, meningitis and blood infections. These infections can be life-threatening. 22. Thyroid test (thyroid-stimulating hormone [TSH] test): Used to check for problems with the thyroid gland. TSH causes the thyroid to make two hormones triiodothyronine (T3) and thyroxine (T4) which help control your metabolism. An underactive thyroid gland (hypothyroidism) can cause weight gain, tiredness, dry skin, constipation, feeling cold and/or frequent menstrual periods. An overactive thyroid gland (hyperthyroidism) can cause weight loss, rapid heart rate, nervousness, diarrhea, feeling hot and/or irregular menstrual periods. 23. Pap test: Test used to screen women for cancer of the cervix. 24. Pelvic exam: Complete physical exam of a woman s external genitals and internal pelvic organs. It s done to monitor overall gynecologic health and to help detect cancers, infections or other abnormalities. 25. Mammogram: X-ray of the breasts used to screen for and/or diagnose breast cancer. Mammograms can detect abnormal growths or changes in the breast tissue before they can be felt by a woman or her doctor. 26. Bone mineral density test: Test that estimates the strength of your bones. 27. Herpes zoster vaccine: Helps prevent shingles (herpes zoster), a painful, often blistering, potentially recurrent rash. It s caused by the varicella-zoster virus, the same virus that causes chickenpox. April 2009 Page 5 of 6
What Are These Screenings? (continued) 28. Human papilloma virus (HPV) vaccine: Helps protect from infection with the types of HPV that cause most cases of genital warts and cervical cancer. 29. Testicular exam: Includes a complete physical examination of the groin and genital organs (penis, scrotum and testicles). A testicular exam can detect the causes of pain, inflammation, swelling, congenital abnormalities (such as an absent or undescended testicle), and lumps or masses that may indicate testicular cancer. 30. Digital rectal exam: Checks for abnormalities of organs or other structures in the pelvic and lower abdominal area. 31. Prostate-specific antigen (PSA) blood test: Measures blood levels of PSA, a substance released by the prostate gland. PSA levels normally increase as the prostate enlarges with age. Inflammation of the prostate gland and prostate cancer also increase PSA levels. These recommendations and the detailed information were created using the following sources: The National Women s Health Information Center (www.womenshealth.gov), a service of the Office on Women s Health in the U.S. Department of Health and Human Services; WebMD (www.webmd.com); Optum Health (www.myoptumhealth.com); and American Academy of Pediatrics (www.aap.org). April 2009 Page 6 of 6