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Healthy Aging
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By Wulf H. Utian, MD, PhD

Women’s Health Consultant; Consultant, Gynecology and Women’s Health, The Cleveland Clinic; Chair Scientific Board, Rapid Medical Research, Inc.; Professor Emeritus, Case Western Reserve University; Visiting Professor, University of Cape Town, South Africa; Honorary Founding President and Executive Director Emeritus, NAMS

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Q: What preventive tests should middle-aged women receive to prevent serious illness?

I'm glad you've asked this question. Midlife is a particularly important time for screening tests—tests that can identify warning signs of serious health conditions such as diabetes, heart disease and cancer early, when they're most easily treated. Various health organizations recommend the following at the noted ages, but you should also talk to your health care professional about screening guidelines with your personal health history in mind. There may be a reason to be screened earlier than the recommendations below suggest.

Condition Screening Recommendation
Blood pressure At least every two years.
Breast cancer Mammogram and clinical breast exam from a health care professional every year for women 40 and older. Women known to be at increased risk may benefit from earlier screenings and/or the addition of breast ultrasound or MRI.
Cervical cancer If you are age 21 or older, have a Pap test every two to three years. Ask your health care provider what’s best for you. If you are age 30 or older, have a human papillomavirus virus (HPV) screening with your Pap test every five years or a Pap test alone every three years. More regular screenings may be recommended by your health care professional. You may discontinue cervical cancer screening after age 65 if you have been screened regularly and are not at high risk for cervical cancer. If you no longer have a cervix and its removal had nothing to do with cervical cancer, you can skip your Pap test. You'll still need an annual gynecological exam, however.
Cholesterol Screening for high cholesterol every five years for Americans over age 20. A fasting "lipoprotein profile" is recommended.
Colorectal cancer Age 50 and older with one of the following screening tests: fecal occult test, barium enema with x-ray, sigmoidoscopy (examination of the rectum and lower colon) or colonoscopy (examination of the entire colon) at regular intervals. Discuss options and procedures with health care professional to determine best screening method and frequency.
Diabetes Fasting plasma glucose (FPG) test every three years beginning at age 45; earlier if you're overweight or have a high risk of diabetes.
Osteoporosis Bone density test beginning at age 65, earlier if significant risk factors for osteoporosis exist.
Skin cancer Annually. Also examine all moles monthly for any changes.