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Screening Guidelines by Age
Adolescents (age 11-19)
Component
When to Start
How Often
Complete Physical Exam
- Height/Weight (check for eating disorders
- Skin exam
- Oral cavity (gingivitis/caries/etc)
- Hearing
- Abuse/Neglect/depression
- BP (normal 120/80)
11-14 years
Three visits (11-14 years, 15-17 years, and 18-21 years)
Females:
- HPV
- Gardasil
- Cervarix
- HPV
Gardasil – Age 11-26
Cervarix – age 10-25
Gardasil – Series of three over six months: 2nd and 3rd dose, two and six months after 1st
Cervarix – Series of three on zero, one, and six month schedule
Syphilis Screening
When sexually active
PRN or with Pap smear. Etc
Males
- Self breast/Testicular exams
Adolescence
Monthly
HIV
Depending on level of sexual activity or IV drug use
Assess knowledge of prevention, contraception, protective barriers, etc.
Tetanus-diphtheria (Td); substitute 1 dose of Tdap (adacel) for Td
As early as age 7
Every 10 years
Meningococcal (Menomune; Menactta; Menveo)
All adolescents ages 11-18
Controversial: Revaccinate once only for high risk (e.g. college freshman living in dorms, military recruits) after 5 years from last
Influenza
Annually
Pneumococcal
Age 19-64 who is a smoker or has asthma
PPD Screening
Once during adolescence
Every two years if at risk or with any exposure to tuberculosis
Young Adults (age 20-39)
Component
When to Start
How Often
Complete Physical Exam
- Height/Weight (check for eating disorders
- Skin exam
- Oral cavity (gingivitis/caries/etc)
- Hearing
- Abuse/Neglect/depression
- BP (normal 120/80)
Age 20
Every 5 to 6 years
Females
- Pap Smear (with GC and Chlamydia screens)
- Cytology (conventional or liquid-based)
- HPV Co-test (cytology + HPV test administered together)
- Self Breast Exam
- Clinical Breast Exam (by a provider)
- HPV
- Gardasil
- Cervarix
- HPV
Pap smear
Age 21; Chlamydia testing for all ≤ 25 years of age
HPV Co-test not to be used for women aged <30 years old
Self Breast exam starting at age 21
Clinical breast exam beginning in adolescence
Gardasil – Age 11-26
Cervarix – age 10-25
Pap smear every 3 years
HPV co-test every 5 years
Self breast exam is optional. Clinical breast exam should occur every 3 years; annually starting at age 40-75
Gardasil – Series of three over six months: 2nd and 3rd dose, two and six months after 1st
Cervarix – Series of three on zero, one, and six month schedule
Males
- Self breast/Testicular exams
Adolescence
Monthly
HIV
Depending on level of sexual activity or IV drug use
Assess knowledge of prevention, contraception, protective barriers, etc.
Blood Pressure
Now
With every health care visit or every two years (normal <120/80)
Total Cholesterol and HDL (or full fasting panel)
Age 20
Every 5 years unless cholesterol > 200mg/dL
Self Skin Exams
Now
Regularly
Tetanus-diphtheria (Td) booster (Td); substitute 1 dose of TDap (Adacel) for Td
- Herpes Zoster (Zostavax)
When was last?
Herpes Zoster vaccine Age 50
Tetanus: Every 10 years
Herpes Zoster: Once
Influenza
Annually
Pneumococcal
Age 19-64 who is a smoker or has asthma
PPD Screening
Young adult
Controversial but annually for high risk populations
Dental Cleaning and Checkup
Now
Every 6-12 months
Middle-Aged Adults (age 40-59)
Component
When to Start
How Often
Complete Physical Exam
- Height/Weight (check for eating disorders
- Skin exam
- Oral cavity (gingivitis/caries/etc)
- Hearing
- Abuse/Neglect/depression
- BP (normal 120/80)
Age 40
Every 5 to 6 years
Females
- Pap Smear (with GC and Chlamydia screens)
- Cytology (conventional or liquid-based)
- HPV Co-test (cytology + HPV test administered together)
- Self Breast Exam
- Clinical Breast Exam (by a provider)
- Mammography
Pap smear Age 21
HPV +/- Co-test for ages 30-65
Self Breast exam now
Clinical breast exam beginning adolescence/now
Mammography beginning at age 40
Pap smear +/- cytology every 3 years
ACOG does not recommend clinical breast examinations every year
Mammography should be performed every one to two years for women ages 40-49, then annually for ages 50-74 or as long as in good health
Males
- Self breast/Testicular exams
- Prostate screening (digital rectal exam and PSA)
Self exams should start as a young adult
Prostate Screening is controversial
- Digital exam beginning at age 40 and PSA at age 40 for men with a family history of prostate cancer or if African American
- All males 50 or older should have a digital rectal exam and PSA test
Self exams should be monthly
Prostate testing is annual
HIV
Depending on level of sexual activity or IV drug use
Assess knowledge of prevention, contraception, protective barriers, etc.
Blood Pressure
Now
With every health care visit or every two years (normal <120/80)
Total Cholesterol and HDL (or full fasting panel)
Age 20
Every 5 years unless cholesterol > 200mg/dL
ECG
Age 40 or baseline or with cardiac risk factors
PRN as indicated
Colorectal Cancer (second leading cause of cancer deaths)
Age 50
Annual Fecal Occult Blood Test
Flexible sigmoidoscopy every 5 years
Total colon examination by colonoscopy every 10 years or by double contrast barium enema every 5-10 years
Glaucoma Screening/Tomometry
Now (normal pressure 10-20 mmHg)
Annually
Self Skin Exams
Now
Regularly
Tetanus-diphtheria (Td) booster (Td); substitute 1 dose of TDap (Adacel) for Td
- Herpes Zoster (Zostavax)
When was last?
Herpes Zoster vaccine Age 50
Tetanus: Every 10 years
Herpes Zoster: Once
Influenza
Annually
Pneumococcal
Age 19-64 who is a smoker or has asthma
PPD Screening
Young adult
Controversial but annually for high risk populations
Dental Cleaning and Checkup
Now
Every 6-12 months
Elderly Adults (ages 60 and over)
Component
When to Start
How Often
Complete Physical Exam
- Height/Weight (check for eating disorders
- Skin exam
- Oral cavity (gingivitis/caries/etc)
- Hearing
- Abuse/Neglect/depression
- BP (normal 120/80)
Laboratory assessments are warranted at this time
Age 60
Every 2 Years
Females
- Pap Smear (with GC and Chlamydia screens)
- Cytology (conventional or liquid-based)
- HPV Co-test (cytology + HPV test administered together)
- Self Breast Exam
- Clinical Breast Exam (by a provider)
- Mammography
Pap smear Age 21
HPV +/- Co-test for ages 30-65
Self Breast exam now
Clinical breast exam beginning adolescence/now
Mammography beginning at age 40
Pap smear +/- cytology every 3 years; discontinue at age > 65-70 with three consecutive normal cytology tests and no abnormal tests in the past 10 years
ACOG does not recommend clinical breast examinations every year
Mammography should be performed every one to two years for women ages 40-49, then annually for ages 50-74 or as long as in good health
Males
- Self breast/Testicular exams
- Prostate screening (digital rectal exam and PSA)
Self exams should start as a young adult
All males 50 or older should have a digital rectal exam and PSA test
Self exams should be monthly
Prostate testing is annual
HIV
Depending on level of sexual activity or IV drug use
Assess knowledge of prevention, contraception, protective barriers, etc.
Blood Pressure
Now
With every health care visit or every two years (normal <120/80)
Total Cholesterol and HDL (or full fasting panel)
Age 20
Every 5 years unless cholesterol > 200mg/dL
ECG
Age 40 or baseline or with cardiac risk factors
PRN as indicated
Colorectal Cancer (second leading cause of cancer deaths)
Age 50
Annual Fecal Occult Blood Test
Flexible sigmoidoscopy every 5 years
Total colon examination by colonoscopy every 10 years or by double contrast barium enema every 5-10 years
Glaucoma Screening/Tomometry
Now (normal pressure 10-20 mmHg)
Annually
Self Skin Exams
Now
Regularly
Tetanus-diphtheria (Td) booster (Td); substitute 1 dose of TDap (Adacel) for Td
- Herpes Zoster (Zostavax)
When was last?
Herpes Zoster vaccine Age 50
Tetanus: Every 10 years
Herpes Zoster: Once
Influenza
Annually
Pneumococcal
Age 65 or older
PPD
Young Adult
Controversial but annually for high risk populations
Dental Cleaning and Checkup
Now
Every 6-12 months
