Prevention Guidelines for Women 40-49

Here are the screening tests and immunizations that most women age 40-49 need. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion. Click to see prevention plans for men and women in different age groups and learn more about each screening:

Screening

Who needs it

How often

Alcohol misuse

All adults and pregnant women

At routine exams

Anemia - Iron Deficiency

All pregnant women

At prenatal visits, especially the first

Asymptomatic Bacteriuria (with urine culture)

All pregnant women

At 12-16 weeks' gestation or the first prenatal visit, if later

Blood pressure

All adults

Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:

Every 2 years - blood pressure reading < 120/80 mm Hg, and

Yearly - systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure

Breast cancer

All women*

Yearly mammogram and clinical breast exam*

Cervical cancer

An update to this recommendation is currently in progress and being reviewed by the USPSTF. The recommendation below may contain information that is out of date. Please consult your healthcare provider.

Women who have been sexually active and have a cervix

Please discuss with your healthcare provider.

The American Cancer Society (ACS) recommends a pap test every 2 years.

The American Congress of Obstetricians and Gynecologists (ACOG) recommends that women age 30 and older get a pap test once every 3 years, and women with certain risk factors (or at increased risk) may need more frequent screening.**
Chlamydia Women at increased risk for infection, and pregnant women At routine exams

Depression

All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

At routine exams

Diabetes Mellitus, type 2

Adults who are asymptomatic with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At routine exams

Gonorrhea

Sexually active women at increased risk for infection, and pregnant women

At routine exams

Hepatitis B virus

All pregnant women

At first prenatal visit

HIV

Anyone at increased risk for infection, and pregnant women

At routine checkups

Lipid Disorders  

All women age 45 and older at increased risk for coronary artery disease

For women aged 19-44, ACOG recommends screening based on risk factors. Please discuss with your healthcare provider.
At least every 5 years

Obesity

All adults

At routine checkups

Preeclampsia

Given the availability of new evidence, USPSTF has decided to update this recommendation. The recommendation below may contain information that is out of date. Please consult your healthcare provider.

All pregnant women

The recommendation below may contain information that is out of date. Please consult your healthcare provider.

At routine checkups

Rh (D) Incompatibility

All pregnant women

First prenatal visit

Rubella

Given the availability of new evidence, USPSTF has decided to update this recommendation. The recommendation below may contain information that is out of date. Please consult your healthcare provider.

All pregnant women

The recommendation below may contain information that is out of date. Please consult your healthcare provider.

At routine checkups

Syphilis

Women at increased risk for infection, and all pregnant women

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your healthcare provider

Counseling

Who needs it

How often

Breast cancer, chemoprevention

An update to this recommendation is currently in progress and being reviewed by the USPSTF.

The recommendation below may contain information that is out of date. Please discuss with your healthcare provider.

Women with high risk

The recommendation below may contain information that is out of date. Please consult your healthcare provider.

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with increased risk

When risk is identified

Breastfeeding

All pregnant women

During pregnancy and after delivery

Diet, behavioral counseling

Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease

When diagnosed

Tobacco use and Tobacco-Caused Disease

All adults

Every visit

Immunization

Who needs it

How often

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All adults

Td: Every 10 years

Tdap: Substitute a one-time dose of Tdap for a Td booster - Once after age 18

Chickenpox (varicella)

All adults ages 19 to 49 and who lack evidence of immunity (i.e., no documentation of prior infection or vaccinations)

Pregnant women should be assessed for evidence of immunity.

Two doses. The second dose should be administered 4 to 8 weeks after the first dose.

Measles, mumps, rubella (MMR)

All adults ages 19 to 49 and who lack evidence of immunity (i.e., no documentation of prior infection or vaccinations)

One or two doses

Flu vaccine (seasonal)

People at risk***

Yearly

Hepatitis A vaccine

People at risk***

Two doses

Schedule:

Zero and 6 to 12 months (Havrix), OR

Zero and 6 to 18 months schedule (Vaqta)

Hepatitis B vaccine

People at risk***

Three doses. Second dose should be administered 1 month after the first dose; the third dose should be administered at least 2 months after the second dose (and at least 4 months after the first dose)

Meningococcal

People at risk***

One or more doses

Pneumococcal (polysaccharide)

People at risk***

One or two doses

* Recommendation from the American Cancer Society (ACS). Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every two years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. The ACS also recommends annual clinical breast exams (CBEs) for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.

** Women 30 and older who have had 3 consecutive negative Pap tests may be screened every 3 years, according to recommendations from the American Congress of Obstetricians and Gynecologists.

*** Exceptions may exist, please discuss with your healthcare provider

Other guidelines are from the USPSTF

Immunization schedule from the Centers for Disease Control and Prevention (CDC)

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