From the Guidelines
Current well-woman health guidelines recommend regular preventive care visits based on age and risk factors, with a focus on reducing morbidity and mortality from common women's health issues. Women aged 21-29 should have cervical cancer screening with Pap tests every 3 years, as recommended by the American Cancer Society 1. From ages 30-65, options include Pap tests every 3 years, HPV testing every 5 years, or co-testing (Pap plus HPV) every 5 years.
- Key recommendations for cervical cancer screening include:
- Women aged 21-29 years: Pap test every 3 years
- Women aged 30-65 years: Pap test and HPV DNA test every 5 years (preferred) or Pap test alone every 3 years (acceptable)
- Women over 65 years: Stop cervical cancer screening if they have had 3 consecutive negative Pap tests or 2 consecutive negative HPV and Pap tests within the last 10 years
- For breast cancer screening, women should undergo regular screening mammography starting at age 45 years, with annual screening for women aged 45-54 years and biennial screening for women aged 55 years and older 1.
- Additional recommendations include:
- Colorectal cancer screening for adults aged 45 years and older, with options including fecal immunochemical test, high-sensitivity guaiac-based fecal occult blood test, multitarget stool DNA test, colonoscopy, CT colonography, or flexible sigmoidoscopy
- Lung cancer screening for current or former smokers aged 55-74 years, with low-dose helical CT
- Prostate cancer screening for men aged 50 years and older, with prostate-specific antigen test and digital rectal examination
- These preventive measures are essential because they help detect conditions early when treatment is most effective, reducing morbidity and mortality from common women's health issues like breast cancer, cervical cancer, heart disease, and osteoporosis.
- It is also important to note that blood pressure should be checked at least every 2 years, cholesterol screening should begin at age 20, and diabetes screening at age 45 or earlier with risk factors.
- Furthermore, bone density screening is recommended for women 65 and older, and sexually active women should receive STI screening based on risk factors.
- Finally, all women should have annual influenza vaccines and age-appropriate immunizations.
From the Research
Well Woman's Health Guidelines for Exams
- The current guidelines for well woman's health exams emphasize the importance of screening for human papillomavirus (HPV) infection, which is the most common sexually transmitted infection in the United States 2.
- HPV screening is effective in identifying precancerous lesions and allows for interventions that can prevent the development of cancer, including anal, cervical, oropharyngeal, penile, vaginal, and vulvar cancers 2.
- Risk factors for persistent HPV infections include a history of multiple sex partners, initiation of sexual activity at an early age, not using barrier protection, other sexually transmitted infections, including HIV, an immunocompromised state, alcohol use, and smoking 2.
- The use of condoms and dental dams may decrease the spread of the virus, and vaccination is the primary method of prevention 2.
- The nonavalent HPV vaccine is effective in preventing the development of high-grade precancerous cervical lesions in noninfected patients, and is ideally administered at 11 or 12 years of age, irrespective of the patient's sex 2.
- A two-dose series of the HPV vaccine is recommended if administered before 15 years of age, however, individuals who are immunocompromised require three doses 2.