Medical Screenings and Tests for Women 35 and Older

Janet O'Mahony, M.D., an Internal Medicine Doctor and a member of Mercy Personal Physicians Downtown in Baltimore, Maryland, recently responded to questions from the women's wellness website, Gloria, regarding when women 35 and older should receive medical tests, screenings and routine exams. Her response is below.

I recommend sitting down with your doctor for a preventive health exam to go over any risk factors like family history of cancer or heart disease, check height and weight, blood pressure and cholesterol. Your doctor can assess if you have increased risk for certain diseases like diabetes, heart disease or cancer.

There are several parts to preventive health screenings. These include screening for heart disease, cancer, vaccines, assessing fertility and contraception needs, mental health screening and geriatric issues.

The first is screening for heart disease and stroke. I check for smoking, high blood pressure, diabetes, cholesterol and family history as well as screen for obesity with height and weight. I encourage healthy eating and regular activity to all my patients. This should be done at least once every five years if everything is normal. This visit typically will involve blood work to check glucose and cholesterol.

Second is cancer screening.  During your visit, I screen for risk factors like smoking, obesity, and family history. There are a few cancers we routinely screen for in average risk patients.

Mammograms are recommended every other year starting at age 50 for average risk women to screen for breast cancer. Women ages 40 to 50 and who are higher risk, are eligible for mammograms as well. Colon cancer screening is recommended starting at age 45 in both men and women. Usually we recommend a colonoscopy but stool tests can be done in lower risk patients. Cervical cancer screening in women consists of a PAP smear every three years between 21 and 29 years old and PAP smear with HPV testing every three to five years in women ages 30 to 65. Lung cancer screening is recommended in smokers (and people who quit smoking within the last 15 years) between the ages of 50 and 77.

It is also recommended adults receive the following vaccines:

• A flu vaccine every fall for all ages
• A COVID vaccine for all ages
• Shingles vaccine for everyone over age 50
• A tetanus vaccine every 10 years
• A Pneumonia vaccine is recommended one time after age 65 but also in other risk groups like people with heart disease and diabetes
• HPV vaccine is recommended at age 11 but you can "catch up" up to age 26 if you did not receive it in childhood

Fertility issues should be addressed as well and this is also a good time to screen and assess risk for sexually transmitted diseases.

We also typically screen for mental health issues like anxiety and depression. For elderly individuals, we screen for fall risks and cognitive decline.

Board Certified in Internal Medicine, Dr. Janet O'Mahony received her medical degree from University of Maryland School of Medicine in Baltimore. She completed her Internship at Baltimore VA Medical Center and Residency at Mercy Medical Center.