Check-up For Women: What Tests Must Be Taken And At What Age

Doctors assure: the best way to avoid diseases of the 21st century is to take the minimum of necessary tests on time and regularly. At what age it is worth undergoing certain examinations, said Olga Belokon, a practicing obstetrician-gynecologist and blogger (@doctor_belokon) with over 1.5 million subscribers, author of the book “I am a woman. Everything about women's health, contraception, hormones and much more” (went on sale in November). Olga is an adept of evidence-based medicine, so feel free to save this check-up to your bookmarks!

Olga Belokon

Practicing gynecologist

If you are between 18 and 39 years old

It is necessary to visit a doctor from time to time, even if you have no complaints, this can help to avoid problems in the future. For example, high blood sugar or high cholesterol levels may not show up in the early stages. A simple blood test can check their levels and start treatment on time.

Screening for arterial hypertension

Check your blood pressure at least every two years. However, if the upper number (systolic pressure) is between 120 and 139 mm Hg. Art. or lower (diastolic pressure) - in the range of 80 to 89 mmHg, should be checked every year. And if the upper indicator becomes more than 140 or the second (lower) value begins to exceed 90, it is time to consult a therapist / cardiologist / family doctor.

Screening for hypercholesterolemia

The recommended age for cholesterol screening for women is 20–45 years. The total cholesterol and its fractions (HDL, LDL, triglycerides) are being investigated. If a normal result is obtained, a second analysis is carried out after 5 years. The study can be done earlier if the nature of the diet has changed a lot and overweight / obesity has appeared. In the presence of diabetes mellitus, cardiovascular disease, kidney disease, etc., more careful monitoring may be required. If the test result is elevated, contact your general practitioner / family doctor for further advice.

Screening for diabetes

If the blood pressure is 140/80 mm Hg. Art. and above, there is obesity or overweight, first-line relatives with type 1 diabetes mellitus, it is imperative to donate fasting blood glucose and (sometimes) glycated hemoglobin once a year.

Visit to the dentist

Visit your dentist regularly once or twice a year for prophylactic professional teeth cleaning and treatment of minor caries when it occurs.

Vaccination

It is advisable to get a flu shot every year. After 19 years of age, vaccinations against tetanus, diphtheria and pertussis are given, if not previously given in adolescence. Then every 10 years revaccination against tetanus and diphtheria is carried out. You can get vaccinated against chickenpox (chickenpox), if you have not had it and have never been vaccinated. In adulthood, the disease is extremely difficult to tolerate. You can also take a blood test for IgG to rubella and measles and, if they are not found, get vaccinated against these diseases. These are live attenuated vaccines that are prohibited during pregnancy. After vaccination, you need to reliably protect yourself for one month. You can get the HPV vaccine up to age 45 (see section on HPV).

Screening for cervical cancer

From the age of 21 (or 3 years after the onset of sexual activity), it is recommended that the Pap test be performed annually or less often if you are doing a Pap test in combination with an HPV test (see the chapter on cervix and HPV).

Breast Cancer Screening

Women under 39 years of age from the middle-risk group, who do not present any complaints, only need breast self-examination and an annual examination by a gynecologist / mammologist. Mammography from 39-40 years old every 1-2-3 years (depending on the country) or after 25-35 years if you are at high risk of breast cancer (BRCA1, BRCA2 mutations, family history of breast cancer, breast irradiation before the age of 30, precancerous processes based on biopsy results, five-year breast cancer risk of more than 1.7% according to the Gail model).

Ovarian Cancer Screening

From 30–35 years old or 5–10 years earlier than the age of the youngest family member with such cancer, in the presence of BRCA1, BRCA2 mutations and intact ovaries; Lynch syndrome (also called hereditary non-polyposis colorectal cancer) and intact ovaries. A blood test for CA-125 and an ultrasound of the pelvic organs are performed annually. Screening is not indicated for women outside the risk group. It is heavily criticized and, to be honest, is not the most reliable, but recommended for lack of a better option.

Screening for sexually transmitted diseases

If you have had unprotected sex and you do not know anything about the presence / absence of these very infections in your sexual partner (see the chapter on testing for infections after unprotected sex).

Screening for skin cancers (melanoma, etc.)

Melanoma is called the queen of all cancers because it is very aggressive, progresses rapidly, and has a small chance of survival. But if you identify it at a very early stage, you can live a very long and happy life. See a dermatologist once a year or two to examine any lesions on your skin. A simple one-hour visit to the doctor every one to two years can save your life.

Fluorography / chest x-ray

It is done once a year or two, starting from the age of 18 (recommendations vary) due to the presence of a tuberculosis epidemic in the countries of the former USSR.

40 and older

We look at the section "Checkup for women 18-39 years old" and continue:

control blood pressure;

cholesterol

blood glucose

visit the dentist

do ovarian cancer screening if you are at risk

visit a dermatologist

screening for STIs if you are at risk

fluorography or chest x-ray every one to two years

Go back to the previous section, all these points are detailed there.

After 40 years added

Colorectal cancer screening

From 50 to 75 years of age or earlier: if you have polyps or inflammatory bowel disease;

if someone in the family has colon cancer (screening starts 10 years earlier than the age of the youngest family member with cancer). The main diagnostic method is colonoscopy. It is performed every 10 years or more often if there are risk factors for colorectal cancer such as ulcerative colitis, a personal or family history of colorectal cancer, and a history of adenomatous polyps.

After 75 years, screening, as a rule, stops, but it is better to clarify this point with the attending physician, since there may be indications for its continuation.

An alternative to colonoscopy in people at moderate risk for colorectal cancer may include:

flexible sigmoidoscopy every 5 years;

double contrast irrigoscopy every 5 years;

CT colonography (virtual colonoscopy) every 5 years;

routine fecal occult blood test annually (cheap, simple, but not very accurate);

an immunochemical analysis for occult blood in the feces, more informative, is done every year;

cologuard - detection of DNA markers and blood in the stool every 3 years

(FDA approved, widely used abroad, how widespread it is in the CIS - it's hard to say).

Visit to an ophthalmologist

An examination by an ophthalmologist is done every 2–4 years between the ages of 40 and 54, and every 1–3 years at the age of 55+ or more if you have pre-existing vision problems or risk of glaucoma.

Mammography

After 40-50 years, every 1-2 years (the start of mammography depends on the recommendations of a particular country, they differ), after 50 years every year.

Vaccination

After age 50, you can get the herpes zoster vaccine (Herpes Zoster).

At the age of 65+, vaccination against pneumococcus is recommended. Flu shot annually. Revaccination against tetanus and diphtheria every 10 years.

Osteoporosis screening

X-ray densitometry is the "gold standard". After 65 years, it is mandatory for all women.

After 50 years - if there have already been bone fractures or there are risk factors for osteoporosis (premature menopause, taking medications, etc.). According to indications, sometimes even earlier than 50 years.

Screening for cervical cancer

A Pap test is not done after age 65 if there have been three negative tests in the last 10 years.

For smokers

If you are a smoker with an index of 30 packs / years (we calculate the smoker's index in packs / years, google and figure it out, everything is SIMPLE!) Or you smoked so much but quit less than 15 years ago, you are shown an annual low-dose CT scan for screening lung cancer at age 55–80 years old. X-rays and fluorography are not a substitute and do not detect lung cancer, sometimes even at the fourth stage! Only low-dose CT is used! It is the only proven and informative method for detecting lung cancer.