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Health Screenings for Women

women screen test Having regular check-ups and getting screening tests are important steps that you can do for yourself. Not all experts, though, agree on which tests women should have or how often these tests should be done. Most of the guidelines below are from the US Preventive Services Task Force (USPSTF). This is an independent group of experts who review studies and develop recommendations for doctors to follow. Keep in mind that if you have symptoms or risk factors for certain conditions, then this will affect how often you are screened.

What to Expect

Blood Pressure Measurement

During blood pressure measurement, a cuff will be wrapped and inflated around your upper arm. The air will be slowly released. A stethoscope or electronic device in the cuff will be used to listen to the pulse beats in your arm. Your "systolic" and "diastolic" blood pressure levels will be measured. These levels correspond to the pressure when your heart contracts and relaxes.
You should have your blood pressure routinely measured. While USPSTF does not specify a screening schedule, blood pressure screening usually takes place at each doctor's visit. If your blood pressure is less than 120/80 mm HG, you may be tested every two years. But, if the systolic number is 120-139 mm HG or diastolic number is 80-90 mm HG, you may be tested every year.

Blood Tests

Since blood travels throughout your body, blood samples can offer a range of information about your health. Usually blood is drawn from your arm with a needle connected to a tube. During your physical exam, you may have a blood test done to check for type 2 diabetes if your blood pressure is over 135/80 mm Hg or you have other risk factors. If you are aged 20 years or older and have increased risk for coronary heart disease, your doctor may also check your cholesterol levels.
USPSTF does not recommend routine screening for conditions like thyroid disorder or anemia. If you have symptoms or risk factors, however, a complete blood count (CBC) may be done to analyze your red blood cells, white blood cells, and platelets.

Urinalysis

An analysis of a urine sample can indicate possible problems, such as diabetes, kidney problems, or bacterial infection. Other than during pregnancy, there are few reasons to have a urinalysis for the purpose of health screening (as opposed to diagnosis). If a urinalysis is indicated for you, you will be asked to urinate in a special container. The urine sample will be tested.

Clinical Breast Exam

During the clinical breast exam, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. While the USPSTF does not have specific recommendations for this, your doctor may check your breasts at your routine physical exam.

Mammogram

On the day of the mammogram, you should not wear powder, cream, or deodorant on your upper body. If you experience breast tenderness before your period, you may want to schedule the test at a point in your menstrual cycle when your breasts are less sensitive. You will undress from the waist up. Your breasts will be pressed between plates, and x-rays will be taken.
USPSTF offers these guidelines for mammograms:
  • If you are aged 40-49 years—The decision to have a mammogram every two years is an individual one. You should make your decision after you understand the risk and benefits that apply to you. Talk to your doctor.
  • If you aged 50-74 years—Have a mammogram every two years.
Talk to your doctor about the right screening schedule for you. If you are at high risk for breast cancer, you will need to have mammograms at an earlier age.

Pap Smear

At your routine physical exam, a vaginal examination may be done. You will lie on your back with your knees bent and your feet in footrests. The doctor will use an instrument called a speculum to look inside your vagina at your cervix. Your doctor may also do a Pap smear. This will involve scraping cells from the cervix. This sample of cells will then be sent to a lab to check for any abnormalities. In some cases, the sample will also be tested to find out whether you have a human papillomavirus (HPV) infection. HPV is a virus that can cause cervical cancer.
USPSTF offers these guidelines for cervical cancer screening in healthy women:
  • If you are aged 21-65 years—It is recommended that you have the Pap test every three years.
  • If you are aged 30-65 and want to be screened less often, it is recommended that you have the Pap test along with the HPV test every five years.
  • If you are aged 65 or older—You may be able to stop having Pap and HPV tests if you have had normal Pap smears in the past and you do not have any other risk factors for cervical cancer
Your doctor can help determine the right screening schedule for you. For example, you will need to have Pap tests done more often if you have abnormal results or certain conditions

Tests for Sexually Transmitted Diseases (STDs)

If you are under the age of 25 and sexually active, then your doctor will likely test you for certain STDs, like chlamydia. If you are 25 and older and are at an increased risk for STDs or have symptoms, then your doctor may test you for certain STDs. Risk factors include having multiple sex partners, having sex with someone who has an STD, or having sex without a condom. Examples of STDs that you may be tested for include:
  • Chlamydia—a sample taken from the vagina or urine
  • Gonorrhea—a sample taken from the cervix, vagina or urine
  • Syphilis—a blood test
  • HIV—a blood test

Colorectal Exams

These important exams screen for colorectal cancers in your digestive tract. If you are aged 50-75 years, USPSTF recommends using one of the following:
  • Fecal occult blood every year—This is a test to detect the presence of blood in the stool.
  • Flexible sigmoidoscopy every five years—This is a visual exam of the rectum and lower portion of the colon or,
  • Colonoscopy every 10 years—This is a visual exam of the rectum and colon.

Skin Exam

While USPSTF does not offer specific guidelines for skin cancer screening, your doctor will most likely exam your skin during your routine physical exam. You doctor will look for suspicious moles that have uneven borders, have more than one color, are asymmetrical in shape, or are a size larger than a pencil eraser. If you notice any new or changing moles, tell your doctor.

Other Health Exams

Beyond your physical exam, it is also important that your oral and eye health are checked.
Dental Exams
The American Dental Association recommends that you have regular dental cleanings and oral exams. This may occur every six months, or more often if you are prone to plaque or gingivitis. Proper dental hygiene also includes:
  • Brushing teeth with fluoride toothpaste after meals or at least twice per day
  • Daily flossing between teeth and gums
Eye Exam
During an eye exam, you may need to read letters on a chart, set at a distance. You may get eye drops to numb your eye or dilate your pupil to test for glaucoma and to check your retina. Your eye specialist (ophthalmologist) may test how your eye moves and responds to light. How often you should have eye exams depends on factors, like your age, medical history, and date of your last exam. The American Academy of Ophthalmology offers these general guidelines:
  • If you are aged 20-39 years—Have an eye exam at least once between the ages of 20-29, and at least twice between the ages of 30-39.
  • If you are aged 40-64 years—Get a baseline screening at age 40, then get follow-up exams based on the results.
  • If you are aged 65 or older—Get an eye exam every 1-2 years.
Getting regular exams can be part of your healthy lifestyle.

RESOURCES

Lab Tests Online—American Association for Clinical Chemistry http://www.labtestsonline.org

Women's Health—US Department of Health and Human Services http://www.womenshealth.gov

CANADIAN RESOURCES

Canadian Women's Health Network http://www.cwhn.ca

Health Canada http://www.hc-sc.gc.ca

References

Breast cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 15, 2014. Accessed May 6, 2014.

Brushing your teeth. Mouth Healthy—American Dental Association website. Available at: http://www.mouthhealthy.org/en/Home-MouthHealthy/az-topics/b/brushing-your-teeth. Accessed May 6, 2014.

Cervical cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 11, 2014. Accessed May 6, 2014.

Colorectal cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 24, 2014. Accessed May 6, 2014.

Diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2014. Accessed May 6, 2014.

Eye exams 101. Eye Care America, Foundation of the American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/living/eye-exams-101.cfm. Accessed May 6, 2014.

HIV infection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2014. Accessed May 6, 2014.

How to get your cholesterol tested. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=541. Updated October 2008. Accessed January 25, 2010.

Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 1, 2014. Accessed May 6, 2014.

Melanoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 15, 2014. Accessed May 6, 2014.

Screening for breast cancer. US Preventive Services Task Force (USPSTF) website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm. Updated July 2010. Accessed May 6, 2014.

Screening for colorectal cancer. US Preventive Services Task Force (USPSTF) website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm. Updated April 2014. Accessed May 6, 2014.

Screening for chlamydial infection. US Preventive Services Task Force (USPSTF). Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/clinic/uspstf/uspschlm.htm. Updated June 2007. Accessed May 6, 2014.

Screening for gonorrhea. US Preventive Services Task Force (USPSTF) website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm. Updated April 2014. Accessed May 6, 2014.

Screening for HIV. US Preventive Services Task Force (USPSTF). Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/clinic/uspstf/uspshivi.htm. Updated April 2013. Accessed May 2, 2014.

Screening for lipid disorders in adults. US Preventive Services Task Force (USPSTF) website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf08/lipid/lipidrs.htm. Updated June 2008. Accessed May 6, 2014.

Screening for skin cancer. US Preventive Services Task Force (USPSTF) website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsskca.htm. Updated February 2009. Accessed May 6, 2014.

Screening for thyroid disease. US Preventive Services Task Force (USPSTF) website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsthyr.htm. Updated January 2004. Accessed May 6, 2014.

Syphilis (primary phase). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 16, 2014. Accessed May 6, 2014.

Understanding blood pressure readings. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings%5FUCM%5F301764%5FArticle.jsp. Updated April 17, 2014. Accessed May 6, 2014.

US Preventive Services Task Force. Screening for high blood pressure: US Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2007;147(11):783-786.

US Preventive Services Task Force. Screening for lipid disorders in adults: US Preventive Services Task Force recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2008.

US Preventive Services Task Force. Screening for type 2 diabetes mellitus in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148(11):846-854.

3/19/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Screening for cervical cancer. US Preventive Services Task Force website. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm. Published March 2012. Accessed March 19, 2012. Saslow D, Soloman D, Lawson H, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: A Cancer Journal for Clinicians. 2012 Mar 14 early online.

7/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Qaseem A, Humphrey LL, et al. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014 Jul 1;161(1):67-72.

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