What test should a 65 year old woman have? Your Guide to Essential Health Screenings

By age 65, life expectancy for women in the U.S. is extended, making preventive care vital for a healthy, active future. Knowing exactly what test should a 65 year old woman have is the best way to proactively manage your well-being. This guide provides an overview of recommended screenings.

Quick Summary

Recommended screenings for a 65-year-old woman typically include a bone density test, continued colorectal cancer screening, and potentially concluding cervical cancer screening. Annual checks for blood pressure, cholesterol, and diabetes, along with a review of immunizations, are also crucial for maintaining long-term health.

Key Points

• Bone Density Test (DEXA Scan): All women aged 65 and older should have a baseline DEXA scan to assess osteoporosis risk.

• Colorectal Cancer Screening : Continue regular screening until at least age 75, with options including a colonoscopy every 10 years or annual stool-based tests.

• Breast Cancer Screening: Most women should continue regular mammograms every 1-2 years, with the specific schedule determined by a doctor and personal risk factors.

• Cervical Cancer Screening: Can often be stopped after age 65 if you have a history of consistently negative Pap or HPV co-tests and no history of a serious abnormality.

• Annual Wellness Visit: Use your yearly check-up to monitor blood pressure, cholesterol, and diabetes risk through routine blood work.

• Immunizations: Ensure you are up-to-date on vaccines for influenza, pneumonia, shingles, and tetanus.

Your Preventive Health Care Checklist at 65

Turning 65 marks a new chapter in life, and with it comes a shift in health care priorities. While many women are in excellent health, age brings a higher risk for certain conditions. Focusing on preventive screenings is a powerful strategy for early detection and treatment, helping to ensure many more years of vitality.

Bone Health: The Essential DEXA Scan

One of the most important screenings for all women aged 65 or older is a bone density test, known as a Dual-Energy X-ray Absorptiometry (DEXA) scan. Osteoporosis, a condition that weakens bones and makes them more susceptible to fractures, is a significant risk for postmenopausal women. The DEXA scan is a quick, painless procedure that measures bone mineral density, typically in the hip and spine.

• Why it's recommended: The scan provides a baseline measurement to assess your risk of osteoporosis and fracture. Your doctor will use the results to determine if medication or lifestyle adjustments are necessary.
• Frequency: Most guidelines recommend an initial DEXA scan at age 65. Depending on the results and your individual risk factors, your doctor may suggest a follow-up scan every two years or less frequently.

Cancer Screenings: A Shifting Schedule

Colorectal Cancer Screening

Screening for colorectal cancer remains a priority. Recommendations vary, but generally continue through age 75 for average-risk individuals. Multiple screening options are available:

• Colonoscopy: A procedure where a doctor uses a flexible tube to examine the entire colon and rectum. If a colonoscopy is chosen, it's typically done every 10 years.
• Stool-based tests: Options include a Fecal Immunochemical Test (FIT) annually or a stool DNA test (sDNA-FIT) every 1 to 3 years. A positive result from a stool-based test will require a follow-up colonoscopy.

Talk to your doctor about which screening method and frequency is right for you, especially if you have a family history or other risk factors.

Breast Cancer Screening

For many women, mammography is a key part of routine care. The guidelines on breast cancer screening frequency for women 65 and older can vary among expert groups, and your personal risk factors play a significant role. Most women with average risk are advised to continue having mammograms every 1 to 2 years, often up to age 75 or even longer, based on a discussion with their doctor. The decision to continue screening depends on your health, personal preferences, and risk factors. Be sure to discuss the benefits and risks with your healthcare provider.

Cervical Cancer Screening

For many women, screening for cervical cancer can stop after age 65, provided they have a history of adequate negative test results and no history of a high-grade precancerous lesion or cancer. Specifically, you may be able to stop if you have had:

• Three consecutive negative Pap test results; or
• Two consecutive negative human papillomavirus (HPV) co-test results.

The most recent test must have been within the past 5 years.

General Health Indicators and Blood Work

An annual wellness visit is the time to review your overall health. Your doctor will likely recommend a series of routine tests to monitor key health indicators.

1. Blood Pressure: Regular blood pressure checks are essential to monitor for hypertension, a major risk factor for heart disease and stroke.
2. Cholesterol (Lipid Profile): A blood test to screen for high cholesterol, which can increase heart disease risk. Testing frequency depends on your individual risk factors.
3. Diabetes Screening: Screening for prediabetes and type 2 diabetes should continue, especially if you are overweight, obese, or have other risk factors.
4. Thyroid Function: A blood test for Thyroid Stimulating Hormone (TSH) is often recommended every 5 years.
5. Urinalysis: A routine test to check for kidney and urinary tract issues.

Immunizations: Staying Protected

Vaccines are not just for children. For women 65 and older, certain immunizations are critical for preventing serious illnesses.

• Annual Flu Shot: Recommended every year to protect against seasonal influenza.
• Pneumococcal Vaccines: Crucial for preventing pneumonia, a significant risk for older adults.
• Shingles (Herpes Zoster) Vaccine: Two doses are recommended for adults at or after age 50 to prevent shingles.
• Tetanus-Diphtheria (Td) and Tdap: A booster is needed every 10 years.
• COVID-19 and other updates: Consult your doctor for the latest recommendations on these vaccines.

Comparing Key Screenings for Women Over 65

Screening	Method	Typical Frequency	Key Benefit	Considerations
Bone Density (DEXA)	Low-dose X-ray	At age 65, then based on results	Detects osteoporosis early	Risk factors like family history, frailty
Colorectal Cancer	Colonoscopy, Stool Test	Varies by test (e.g., 10 yrs for colonoscopy)	Screens for polyps and cancer	Personal and family history
Breast Cancer	Mammogram	Every 1-2 years (up to 75+)	Early detection of tumors	Discussion with your doctor based on risk
Cervical Cancer	Pap Test/HPV Test	Can often stop if prior tests were clear	Detects cervical cell changes	History of normal test results, age
Cholesterol	Blood Test	Varies; at least every 5 years	Screens for heart disease risk	Weight, family history, lifestyle

Creating a Personalized Health Plan with Your Doctor

The information provided is a general guideline. Your individual health history, genetic factors, and lifestyle will determine the specific tests and schedule most appropriate for you. For instance, if you have a family history of a certain condition, your screening might start earlier or be more frequent. An important part of proactive care is being an active partner with your health care provider.

During your annual check-up, ask questions and be open about your lifestyle. A comprehensive plan should be more than just tests; it should also include a discussion of healthy habits like diet, exercise, and stress management. By working closely with your doctor, you can create a personalized road map for a healthy and fulfilling life after 65. For more detailed information on specific health topics, visit the authoritative source at MedlinePlus.

Conclusion

As you reach and pass the age of 65, the focus of medical care shifts towards targeted screenings and preventive measures. For women, this includes a vital DEXA scan for bone density, continuing colorectal and often breast cancer screenings, and managing general health markers through regular blood work. By staying informed, having an open dialogue with your healthcare provider, and adhering to recommended immunization schedules, you can take control of your health and set the stage for many vibrant years ahead.

Frequently Asked Questions

What is the most important test for a 65-year-old woman?

While many tests are important, the bone density test (DEXA scan) is specifically recommended for all women at or after age 65 to screen for osteoporosis.

Can I stop having mammograms after I turn 65?

Not necessarily. The decision to stop mammograms depends on your individual health and risk factors. Many women continue regular screening until at least age 75, and you should discuss your specific situation with your doctor.

What kind of doctor should I see for these screenings?

Your primary care physician can manage most of these screenings. They will coordinate specialized tests, like mammograms or colonoscopies, with the appropriate specialists.

When can a woman stop having cervical cancer screening?

A woman can often stop screening after age 65 if she has had a history of three consecutive negative Pap test results or two consecutive negative HPV co-tests within the past 10 years, and the most recent test was within 5 years.

Are there alternatives to a colonoscopy for colorectal screening?

Yes, several stool-based tests are available, such as the Fecal Immunochemical Test (FIT) or a stool DNA test (sDNA-FIT). If a stool-based test is positive, a follow-up colonoscopy will be necessary.

What vaccines are recommended for women at 65?

At this age, it is crucial to get an annual flu shot, the pneumococcal vaccine, and the shingles vaccine. A tetanus-diphtheria booster is also recommended every 10 years.

What if I have a family history of a certain condition?

If you have a personal or family history of specific conditions, your screening recommendations may be different. Always inform your doctor about your health history so they can create a personalized screening plan.

Is the DEXA scan painful?

No, a DEXA scan is a quick and painless procedure. It involves lying on a table while a scanner passes over your body, measuring your bone density.