Essential Screening Tests Every Woman Needs

Why Screening Tests Are Important

Getting the right screening test at the right time is one of the most important things you can do for your health. Screenings find diseases like cancer or diabetes early, often before you have symptoms, and when they're easier to treat. Which test you should have depends on your age and your risk factors. Learn more about the screenings your doctor may recommend for you.

Breast Cancer

Early detection of breast cancer greatly improves your odds for survival. That's because the smaller the cancer is when it's found, the better the chance for a surgical cure. Smaller breast cancers are also less likely to have spread to lymph nodes and other organs such as the lungs and brain. If you're in your 20s or 30s and do not have known breast cancer risk factors, a clinical breast exam by a health professional should be part of your regular health exam once every three years.

Screening With Mammography

Talk to your doctor about breast cancer screening. The American Cancer Society recommends yearly screening for women at average risk beginning at 40. However, the U.S. Preventive Services Task Force recommends routine screening mammograms every two years from ages 50 to 74. These low-dose X-rays can sometimes detect a breast mass three years before you can feel it. But a normal mammogram does not completely rule out the possibility of breast cancer.

Cervical Cancer

The cervix is the part of the uterus that extends into the vaginal cavity. Persistent infection with the human papillomavirus (HPV) is the major risk factor for cervical cancer (shown here, magnified). Routine screening can find it early, when it's highly curable. It can also find abnormal precancerous cells on the surface of the cervix so they can be removed before they turn into cancer.

Screening for Cervical Cancer

Doctors use a Pap test to screen for cancer of the cervix. In the office, the doctor collects a sample of cells from your cervix. These are examined in the lab to find precancerous and cancer cells. The screening test should start at age 21. It's very effective in both preventing and finding cervical cancer early enough to cure it.

A Vaccine for Cervical Cancer

The FDA has approved a vaccine -- Gardasil -- for girls and women between the ages of 9 and 26. It protects them from four strains of HPV, the virus that is a leading cause of cervical cancer. A second vaccine, Cervarix, is approved for use in girls and women between the ages of 10 and 25, and targets two strains of HPV. Not all cervical cancers are due to HPV, and other strains of HPV can still cause cancer that neither vaccine protects against, so it's still important to have routine Pap tests to screen for cervical cancer.

Osteoporosis and Fractured Bones

Osteoporosis is a condition in which bones become weak and fragile. It's caused by bone loss, which accelerates in women after menopause. The first symptom is often a painful bone fracture that can occur with only a minor fall, blow, or even just a twist of the body. It is possible to both prevent and treat osteoporosis, which threatens over half of U.S. adults aged 50 and over.

Osteoporosis Screening Tests

A test called Dual Energy X-ray Absorptiometry (DXA) can measure bone mineral density and detect osteoporosis before fractures occur. It can also help predict the risk of future bone fractures. Bone density testing is recommended for all women 65 years of age and older. It's also recommended for middle-aged women younger than 65 who have risk factors for osteoporosis.

Skin Cancer

The most dangerous form of skin cancer is melanoma (shown here). It's a malignancy that affects the cells that produce pigment in the skin. Some people may have a genetic risk factor for melanoma. And the risk increases with overexposure to the sun and sunburn. Basal cell and squamous cell skin cancers are common non-melanoma skin cancers. Early treatment of skin cancer can be effective.

Screening for Skin Cancer

The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine cancer checkup.

High Blood Pressure (Hypertension)

Your risk for high blood pressure increases with age. It's also related to your weight and certain lifestyle habits. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm. Treating high blood pressure can reduce your risk of heart disease, stroke, and kidney failure. Finding out you have high blood pressure and then working with your doctor to manage it can pay huge health dividends.

Screening for High Blood Pressure

Blood pressure is expressed as two numbers. The first (systolic) is the pressure of your blood against your artery walls when the heart beats. The second (diastolic) is the pressure between beats. Normal adult blood pressure is less than 120/80. High blood pressure is at or above 140/90. A reading between those two is considered prehypertension. Your doctor can advise you as to how often to have your blood pressure checked.

Cholesterol Levels

A high level of LDL cholesterol is a major factor that increases the risk of atherosclerosis -- hardening and narrowing of the arteries caused by plaque (seen here in orange). It can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Other atherosclerosis risk factors are high blood pressure, diabetes, and smoking. Lifestyle changes and medications can lower your risk of heart disease.

Determining Cholesterol Levels

Doctors screen for problems with cholesterol by using a fasting blood lipid panel. That's a blood test that tells you your levels of total cholesterol, LDL "bad" cholesterol, HDL "good" cholesterol, and triglyceride (blood fat). Management decisions are based on the results. For adults 20 years or older, you should have a new panel done at least every five years.

Type 2 Diabetes

One-third of the people in the U.S. with diabetes don't know they have it. The sixth leading cause of death in the U.S., diabetes can lead to a vast array of complications such as heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), and nerve damage. But, especially when found early, diabetes can be controlled and complications avoided with diet, exercise, and weight loss.

Screening for Type 2 Diabetes

A test known as fasting plasma glucose is most often used to screen for diabetes and prediabetes. Blood is drawn after you've fasted at least eight hours. A blood sugar level of 100 to 125 indicates prediabetes. And 126 or higher indicates diabetes. If you're healthy and have a normal risk of diabetes, you should have the test every three years starting at age 45. If you have a higher risk, get tested earlier and more often.

Human Immunodeficiency Virus (HIV)

HIV is the virus that causes AIDS. It's in the blood and other body secretions of infected individuals, even when there are no symptoms. It can spread from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. But, early treatment with anti-HIV medications may help the body's immune system fight the virus.

HIV Screening Tests

HIV-infected individuals can remain symptom free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It's possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you are infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.

Preventing the Spread of HIV

Most newly infected individuals test positive by two months after infection. But in rare cases it may take up to six months for an ELISA test to turn positive after exposure to HIV. Abstinence or using latex barriers such as a condom or a dental dam is necessary to avoid potential infection of HIV and other sexually transmitted infections. If you have HIV and are pregnant, talk with your doctor about what needs to be done to reduce the risk of HIV infection in your unborn child.

Colorectal Cancer

Colorectal cancer is the second most common cause of death from cancer overall, and ranks third for women after lung and breast cancer. The majority of colon cancers develop from colon polyps that are growths on the inner surface of the colon. After cancer develops it can invade or spread to other parts of the body. The way to prevent colon cancer is to remove colon polyps before they turn cancerous.

Screening for Colorectal Cancer

A colonoscopy is a common screening test for colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can often be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon. If you are at average risk, screening usually starts at age 50.

Glaucoma

Glaucoma is a condition that can result in blindness due to damage to the optic nerve. Primary open angle glaucoma is the most common type. This glaucoma often produces no symptoms until it is too late and vision loss has begun. There is good evidence that treating elevated eye pressure in glaucoma can prevent blindness.

Glaucoma Screening

How often you should have an eye exam that includes measuring the pressure inside the eye depends on your age and risk factors. African-Americans, people older than 60, family history of glaucoma, personal history of eye injury, and steroid use are risk factors. For healthy individuals under 40 and without increased risk, routine screening every two to four years is recommended.

Importance of Health Screening

Being proactive and discussing screening tests with your doctor makes good health sense. Some tests, such as a Pap test or breast exam should be a routine part of every woman's health care. Other tests become more or less important based on your risks. Proper screening won't always prevent a disease. But it can find a disease early enough to give you the best chance of overcoming it.

Reviewed by Laura J. Martin, MD on June 29, 2011
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