Regular health screenings are vital for maintaining good health and preventing potential health issues. For women, these screenings are tailored to various life stages, addressing unique health needs at each age. Women can proactively manage their health and well-being by understanding which screenings are essential and when to get them. This comprehensive guide outlines the critical health screenings for women by age, ensuring that you stay informed and healthy at every stage of life.
Health Screenings in Your 20s
1. Annual Physical Exam
An annual physical exam is the cornerstone of preventive health care. During this visit, your healthcare provider will check your overall health, discuss your medical history, and provide personalized health advice.
2. Pap Smear and HPV Test
Cervical cancer is a preventable disease due to the long pre-invasive stage. Early detection and appropriate treatment are possible if robust screening is implemented. Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer. Starting at age 21, women should have a Pap smear every three years to screen for cervical cancer. At age 30, the Pap smear can be combined with an HPV test, and if both are normal, the interval can extend to every five years. (Kang, M. et al., 2020), (Sachan, P. L. et al., 2018), (Pankaj, S. et al., 2018)
3. Sexually Transmitted Infection (STI) Screenings
Sexually active women should be tested for STIs, including chlamydia, gonorrhea, syphilis, and HIV, based on risk factors and lifestyle. We are living in the 21st century in the world's most medically sophisticated, technologically proficient country. Yet, incredibly, sexually transmitted infections (STIs) are still a major population health challenge. The recent surge in the incidence rates for common, largely preventable STIs in the United States has raised serious concerns and prompted discussions about the effectiveness of current prevention and screening strategies.
The Centers for Disease Control and Prevention currently recommends annual screening for chlamydia and gonorrhea in all sexually active women younger than the age of 25 and a “risk-based” screening approach for women outside of this age bracket. (Hull, S. et al., 2017), (Yarbrough, M. L., & Burnham, C. A. D. 2016), (Taylor, M. M. et al., 2016)
4. Breast Self-Exams
While formal mammograms aren't typically recommended until later, women in their 20s should become familiar with their breasts and perform regular self-exams to detect any unusual changes. A breast self-exam (BSE) is performed by the patient. In less-developed countries where imaging and CBEs are not as readily available, BSEs are often the only method for early detection of breast cancer. Even in the United States, BSEs are valuable for women who are younger than the age of 40 or 50 years, the age at which mammography is recommended (depending on the guideline), and who are at higher risk of mortality from breast cancer due to race or family history.
In women presenting for evaluation of breast lumps, there is no significant difference between CBEs and BSEs. However, the majority of breast cancers are detected by patients. This suggests that BSEs are important and do detect cancer. Despite controversial guidelines, women should continue to perform BSEs for early breast cancer screening. (Huang, N. et al., 2022), (Aikman, S. N. et al., 2017), (Moreno, X. M. 2019)
5. Skin Cancer Screening
Skin cancer is among the most common cancers in men and women in the United States, and is classified as either nonmelanoma skin cancer (NMSC) (ie, basal cell and squamous cell cancers) or melanoma skin cancer. Although NMSC represents more than 97% of skin cancers, melanoma skin cancer is the primary public health concern with a higher case-fatality rate.
The rationale for skin cancer screening is to detect skin cancers, particularly melanoma, earlier in their clinical course than would happen in usual care, potentially allowing for earlier and more effective treatment. Primary care physicians or dermatologists can perform visual skin cancer screening of the whole or partial body to detect suspicious lesions for potential biopsy.
Women should perform monthly skin self-examinations to check for new or changing moles. A professional skin exam by a dermatologist is recommended for those with a family history of skin cancer or significant sun exposure. (Wernli, K. J. et al., 2016), (Bibbins-Domingo, K. et al., 2016), (Eisemann, N. et al., 2014)
Health Screenings in Your 30s
1. Continued Pap Smear and HPV Testing
Continue with Pap smears and HPV tests as recommended, generally every three to five years, depending on previous test results.
2. Blood Pressure Check
Over the last 2 decades, mounting evidence has highlighted differences between women and men in the manifestation of common cardiovascular diseases (CVDs). A prevailing perception is that women are affected by the same types of CVD that affect men, albeit with delayed onset and often atypical symptoms. However, for ischemic heart disease (IHD) and heart failure (HF), it is now increasingly recognized that women are more likely than men to develop coronary microvascular dysfunction (CMD) and HF with preserved ejection fraction (HFpEF), especially in the setting of vascular risk factors such as hypertension. Blood pressure should be checked at least every two years. High blood pressure can lead to heart disease and stroke, so regular monitoring is essential. (Ji, H. et al., 2020), (Siu, A. L., & US Preventive Services Task Force*. 2015).
3. Cholesterol Test
Starting at age 20, cholesterol should be tested. Women with risk factors such as obesity, diabetes, or a family history of heart disease may need more frequent testing.
Several studies have reported that high serum cholesterol in adults is associated with cardiovascular events in the future. In CARDIA (Coronary Artery Risk Development in Young Adults) study for young people aged 18 to 30 years, the risk for coronary calcium, a strong predictor of future coronary heart disease, was elevated for those with low‐density lipoprotein (LDL) levels of more than 160 mg/dL compared with those with LDL levels of <70 mg/mL. (Peters, S. A. et al., 2016), (Jeong, S. M. et al., 2018)
4. Diabetes Screening
Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease.
Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment. Women should have a diabetes screening if they have high blood pressure, high cholesterol, or other risk factors. Typically, this involves a fasting blood glucose test or an HbA1c test. The diagnosis can be made with a fasting plasma glucose level of 126 mg per dL or greater; an A1C level of 6.5% or greater; a random plasma glucose level of 200 mg per dL or greater; or a 75-g two-hour oral glucose tolerance test with a plasma glucose level of 200 mg per dL or greater. (Pippitt, K., Li, M., & Gurgle, H. E. 2016), (Garrison, A. 2015).
5. Thyroid Function Test
A thyroid function test is recommended for women in their 30s, especially if they experience symptoms of thyroid imbalance such as fatigue, weight changes, or menstrual irregularities.
Thyroid dysfunction during pregnancy is also common, with a prevalence of 2%–4%. Maternal thyroid dysfunction is associated with an increased risk of various adverse maternal and child outcomes, including miscarriage, intrauterine growth retardation, hypertensive disorders, preterm delivery, and a decreased child IQ. During pregnancy, profound changes in thyroid physiology occur to provide sufficient thyroid hormone (TH) to both the mother and fetus. (Medici, M. et al., 2014), (Medici, M. et al., 2015)
Health Screening After 30s
In your 40s, start mammograms, and colorectal cancer screenings, and consider bone density tests. Regular eye exams and mental health screenings are important. In your 50s, continue mammograms and colorectal screenings, begin bone density tests, and maintain heart health monitoring. Hearing tests and a hepatitis C screening are recommended. In your 60s and beyond, continue with mammograms, colorectal screenings, bone density tests, and heart health checks. Add eye exams, lung cancer screening for former heavy smokers, vaccinations for flu, shingles, pneumococcal diseases, and cognitive health assessments.
Conclusion
Regular health screenings are a crucial part of maintaining good health and preventing disease. By staying informed about the recommended screenings for each stage of life, women can take proactive steps to protect their health and well-being. Always consult with your healthcare provider to personalize your screening schedule based on your individual health needs and risk factors. Remember, early detection is key to effective treatment and better health outcomes.
References
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Sachan, P. L., Singh, M., Patel, M. L., & Sachan, R. (2018). A study on cervical cancer screening using pap smear test and clinical correlation. Asia-Pacific journal of oncology nursing, 5(3), 337-341.
Pankaj, S., Kumari, A., Kumari, S., Choudhary, V., Kumari, J., Kumari, A., & Nazneen, S. (2018). Evaluation of sensitivity and specificity of pap smear, LBC and HPV in screening of cervical cancer. Indian Journal of Gynecologic Oncology, 16, 1-5.
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