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Since 2010, National Women’s Health Week has kicked off every year on Mother’s Day, encouraging women of all ages to prioritize their physical and emotional well-being. It’s a great time to update medical screenings, which are designed to detect hidden health issues early when they are easier to treat.
Start with an annual physical examination, including a blood pressure check, weight measurement, and blood cholesterol test to assess your risk of heart disease — the leading cause of death among women. Your primary care provider will ask questions about alcohol, tobacco, and drug use; intimate partner violence (domestic abuse); and mental health concerns like depression and anxiety which are twice as common in women. These yearly screenings help identify any need for intervention or treatment.
An annual well-woman visit with your gynecologist, different from a yearly physical, is recommended from ages 13 to 65. Your provider will perform a breast exam and a pelvic exam if needed, which includes palpation of the uterus and ovaries. The first Papanicolaou (Pap) smear is recommended at age 21, then every three years until age 65. The Pap smear — a painless swab of the cervix — screens for premalignant cells and is credited for the 50% drop in U.S. cervical cancer rates since 1970. You may also be checked, via cervical swab, for certain sexually transmissible infections, including high-risk human papilloma virus (HPV), which causes 95% of all cervical cancer, as well as chlamydia and gonorrhea. Your gynecologist will decide whether to continue well-woman visits past age 65.
Mammography screening has cut the number of deaths from breast cancer nearly in half since 1975, with 42,500 lives estimated to be lost this year. It is recommended that women have their first mammogram at age 40 — lowered last month from age 50 by the United States Preventive Services Task Force (USPSTF) —then every one to two years until age 74. Some women may require different screening schedules or additional imaging, like breast sonograms or MRIs.
Osteoporosis — a disease causing fragile, porous bones — afflicts eight million Americans, 80% of them women. It’s the most common cause of potentially deadly hip fractures. A bone mineral density (BMD) test can detect early bone loss (osteopenia), allowing for prompt lifestyle interventions or prescription medical treatment like alendronate (Fosamax). BMD screens are recommended every two years starting at age 65, or at age 50 for those with risk factors like smoking or chronic steroid use.
Lung cancer is the number one cancer killer of American women, the majority of whom smoked. Low-dose computerized tomography (LDCT) of the chest can spot malignancies early, drastically improving survival rates in women and men. If you are between the ages of 50 and 80, and have smoked a pack of cigarettes a day for 20 years—-even if you’ve quit—-ask your provider about yearly LDCT screening.
The age for colorectal cancer screening — the third most common malignancy in American women — recently dropped from 50 to 45, prompted by a steady increase in colon cancer rates in younger people of both sexes. Discuss the various screening options with your primary care provider: a yearly over-the-counter fecal blood test; a fecal test for abnormal DNA, such as Cologuard, every one to three years; an in-office flexible sigmoidoscopy every five years; a virtual colonoscopy (done with CT) every five years; or a colonoscopy every 10 years. If you are a senior, your practitioner will help you decide the benefit of testing beyond age 75.
Other important health screens, for men too, include dental check ups every six to 12 months, vision testing starting at age 40, and at least one Hepatitis C and HIV blood test in your life after age 18. The USPSTF does not recommend annual skin screening, but encourages self-monitoring. A list of all available health screening tests for women can be found here.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.