Dear Dr. Dave & Dr Dee,
I'm 51 years old, and haven't seen a doctor in over three years and I am uncomfortable with pap smears in particular and wondered if maybe that is why I am reluctant to go to the doctor? I have always had a normal exam and feel healthy, so how much longer can I wait to have a check-up?
Signed,
Reluctant patient
Dear Reluctant patient,
Regular physical exams are important in order to stay healthy and to prevent problems from becoming worse. For example, age 50 and above is the recommended age for colon cancer screening, and you are overdue for your clinical breast exam and mammogram. Many diseases, if caught early, can be treated and cured.
Some women feel more comfortable seeing a female physician for physical exams and pap smears. Your health insurance company can give you recommendations for female gynecologists or family physicians in your area.
A Pap test is recommended every three years, but is only one of many important health screening exams for women. In brief are health exams for women as outlined by the U.S. Department of Health & Human Services (2008).
12 General Screenings and Immunizations for Women (http://www.womenshealth.gov/screeningcharts/general/)
These are guidelines only. Your doctor will personalize the timing of each test immunization to meet your health care needs.
1. General Health
a. Full checkup, including weight and height: discuss with your doctor or nurse.
b. Thyroid test: every 5 years beginning at age 35.
2. Heart Health:
a. Blood pressure every two years beginning at age 18. Helps detect high blood pressure (blood flow resistance) that could lead to risk of heart attack, stroke, heart failure, and kidney damage.
b. Cholesterol test: start at age 20, discuss with your doctor or nurse. Undesirable levels of cholesterol can raise the risk of heart attack and stroke.
3. Bone Health: Bone mineral density test, discuss with your doctor or nurse. If age 65 or older, then get tested at least once.
4. Diabetes: blood glucose test every 3 years beginning at age 45 or earlier if at risk for diabetes.
5. Breast Health: monthly self-exam; mammogram every 1-2 years beginning at age 40; discuss with your doctor or nurse.
6. Reproductive Health:
a. Pap test and pelvic exam: every 1-3 years if you have been sexually active or are older than 21. Age 65 or older, discuss with your doctor or nurse.
b. Chlamydia test: yearly age 18 - 25 if sexually active. Over age 25, get this test if you have new or multiple partners.
c. Sexually transmitted infection tests: Both partners should get tested, including HIV before initiating sexual intercourse.
7. Mental Health Screening: discuss with your doctor or nurse.
8. Colorectal Health: yearly screening for colon and rectal cancer should begin at age 50 or sooner if at high risk. Frequency of exam depend on type of screening procedure such as yearly fecal occult blood test (FOBT), flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years.
9. Eye and Ear Health:
a. Eye exam any time you have a problem with your eyes, or at least once between the ages of 20-29, at least twice between the ages of 30-39, every 2 to 4 years between the ages of 40 and 64, and every 1-2 years after age 65.
b. Hearing Test: every 10 years starting at age 18, then every 3 years after age 50.
10. Skin Health: monthly mole self-exam; by a doctor every 3 years beginning at age 20, then every year after age 40. To check for skin cancer, your doctor examines your skin for moles.
11. Oral Health: Dental exam 1-2 times a year.
12. Immunizations:
a. Influenza vaccine: age 18 to 49 discuss with your doctor or nurse; age 50 and older every year.
b. Pneumococcal: age 65 or older one time.
c. Tetanus-Diphtheria Booster vaccine: every 10 years.
d. Human papillomavirus vaccine (HPV): up to age 26, discuss with your doctor or nurse.
e. Meningococcal vaccine: discuss with your doctor or nurse if attending college.
f. Herpes zoster vaccine (to prevent shingles): starting at age 60, one time only, ask your doctor if it is okay to get it.
For more information, go to http://www.womenshealth.gov/screeningcharts/general/