What guidance can be given to a 33-year-old female with an unremarkable wellness exam?

From the Guidelines

For a 33-year-old female with an unremarkable wellness exam, I recommend continuing annual preventive care visits and focusing on key health maintenance strategies, including cervical cancer screening with Pap tests every 3 years, as suggested by the American College of Physicians 1. The patient should maintain a balanced diet rich in fruits, vegetables, lean proteins, and whole grains while limiting processed foods and excessive alcohol. Aim for at least 150 minutes of moderate-intensity exercise weekly, including both cardiovascular and strength training activities. Ensure adequate sleep (7-9 hours nightly) and practice stress management techniques such as mindfulness or meditation. Stay current with vaccinations, including annual influenza vaccine and Tdap every 10 years. Perform monthly breast self-exams and discuss family history of breast cancer to determine appropriate screening, although the USPSTF recommends against routine screening mammography in women aged 40 to 49 years 1. Practice safe sex and consider contraceptive options if pregnancy prevention is desired. Limit alcohol to one drink daily and avoid tobacco products completely. These preventive measures help maintain overall health by reducing chronic disease risk, supporting immune function, and enabling early detection of potential health concerns. It is also important to note that the guidelines for cervical cancer screening agree that HPV tests alone or in combination with cytology should not be used for primary screening in women younger than 30 years, due to the high prevalence of HPV infection among women in this age group 1.

From the Research

Guidance for the Patient

The patient, a 33-year-old female, has undergone a wellness exam with unremarkable results. Based on the available evidence, the following guidance can be provided:

• The patient should be informed about the importance of regular health checks, as they can lead to increased detection of chronic diseases, such as depression and hypertension, and moderate improvements in controlling risk factors, such as blood pressure and cholesterol 2.
• The patient should be encouraged to discuss prevention strategies and receive recommended clinical preventive services, which can lead to the identification of previously unrecognized diagnoses and improve health outcomes 3.
• The patient should be informed about the importance of cervical cancer screening and HPV vaccination, as HPV is a major risk factor for cervical cancer 4, 5.
• The patient should be screened for various health conditions, including obesity, cardiovascular risk factors, depression, intimate partner violence, and unhealthy alcohol and drug use, as recommended by the USPSTF 6.
• The patient should be advised to follow the recommended immunization schedule, including vaccinations against influenza, tetanus, measles, mumps, and rubella, varicella, meningococcus, and human papillomavirus 6.

Recommended Screening Tests

The patient should undergo the following screening tests:

• Cervical cancer screening, as recommended by the USPSTF 6.
• Screening for sexually transmitted infections, based on age and risk factors 6.
• Screening for obesity and other cardiovascular risk factors 6.
• Screening for depression and intimate partner violence 6.

Importance of Prevention Strategies

The patient should be encouraged to discuss prevention strategies with her healthcare provider, including:

• Healthy diet and physical activity 2.
• Stress management and mental health 2.
• Safe sex practices and HPV vaccination 4, 5.
• Regular health checks and screening tests 2, 3.