Prevention Guidelines for Women 40 to 49

ScreeningWho needs itHow often
Type 2 diabetes or prediabetesAll adults starting at age 45 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetesAt least every 3 years
Alcohol misuseAll adultsAt routine exams
Blood pressureAll adultsYearly checkup if your blood pressure is normal. Normal blood pressure is less than 120/80 mmHg.1 If your blood pressure reading is higher than normal, follow the advice of your healthcare provider. 
Breast cancerAll women2Screening with a mammogram every year is an option starting at age 40. Talk to your healthcare provider regarding your recommended frequency depending on your risk factors.
Cervical cancerAll women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious precancerWomen between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 5 years. This is the preferred approach. But it is also acceptable to continue to have Pap tests alone every 3 years.
Colorectal cancerWomen of average risk ages 45 years and olderSeveral tests are available and used at different times. Tests include: Flexible sigmoidoscopy every 5 years, or CT colonography (virtual colonoscopy) every 5 years, or Colonoscopy every 10 years, or yearly fecal occult blood test, or yearly fecal immunochemical test every year, or stool DNA test, every 3 years. You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your doctor about which test is best for you. Some people should be screened using a different schedule because of their personal or family history. Talk with your doctor about your health history and what colorectal cancer screening schedule is best for you.
ChlamydiaWomen at a higher risk for infectionAt routine exams if at risk
DepressionAll adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-upAt routine exams
GonorrheaSexually active women at a higher risk for infectionAt routine exams if at risk
Hepatitis CAdults at a higher risk; 1 time for those born between 1945 and 1965At routine exams if at risk
HIVAll womenAt routine exams
Lipid disordersAll women age 45 and older at a higher risk for coronary artery diseaseFor women ages 19 to 44, screening should be based on risk factors; talk with your healthcare providerAt least every 5 years
ObesityAll adultsAt routine checkups
SyphilisWomen at a higher risk for infectionAt routine exams if at risk
TuberculosisAdults at a higher risk for infectionCheck with your healthcare provider.
VisionAll adults3Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare provider for exam frequency.
CounselingWho needs itHow often
Breast cancer, chemopreventionWomen at high riskWhen risk is identified
BRCA mutation testing for breast and ovarian cancer susceptibilityWomen with a higher riskWhen risk is identified
Diet and exerciseAdults who are overweight or obeseWhen diagnosed and at routine exams
Domestic violenceWomen of child-bearing age and older women with a higher riskAt routine exams
Sexually transmitted disease preventionAdults at a higher risk for infectionAt routine exams
Tobacco use and tobacco-related diseaseAll adultsEvery exam
ImmunizationWho needs itHow often
Tetanus/diphtheria/pertussis (Td/Tdap) boosterAll adultsTd: every 10 yearsTdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years
Chickenpox (varicella)All adults in this age group who have no record of previous infection or vaccinations2 doses; the second dose should be given at least 4 weeks after the first dose
Measles, mumps, rubella (MMR)All adults in this age group who have no record of previous infection or vaccinations1 or 2 doses
Flu vaccine (seasonal)All adultsYearly, when the vaccine becomes available in the community
Hepatitis A vaccinePeople at risk42 doses given 6 months apart
Hepatitis B vaccinePeople at risk53 doses; the second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose).
Haemophilus influenzae type B (HIB)People at risk1 to 3 doses
MeningococcalPeople at risk**1 or 2 doses
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)People at risk1 or 2 doses

1 American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines

2 American Cancer Society

3 Recommendation from the American Academy of Ophthalmology

4 For complete list, see the CDC website

5 Exceptions may exist. Please talk with your healthcare provider.

Other guidelines from the USPSTF

Immunization schedule from the CDC