Essential Screenings Every Woman Should Get

Regular visits to your doctor may seem like a chore, but for women, certain screenings and tests may add years to your life.

Some tests, like a Pap smear or blood cholesterol check, are ones you’ve probably gotten for years. But others are recommended on the basis of age or lifestyle, or are new and may not be familiar to you. For several tests, the recommended age to start screening has been lowered.

It’s crucial to get all the tests you’re eligible for, says Janelle Duah, MD, a primary care physician and an assistant professor of medicine at Yale School of Medicine in New Haven, Connecticut. “Screenings allow us to diagnose an illness before it becomes more advanced and harder to manage,” she says.

In some cases, the screen provides all the information the physician needs to make a diagnosis. Other times, results reveal potential issues and must be followed up with more comprehensive diagnostic tests.

Because of women’s more complex reproductive biology, they have more screening tests than men. Fortunately, they’re generally better at prioritizing their health and ensuring they happen, Dr. Duah says.

It’s now easier than ever to stay current on screening tests, thanks to electronic medical records, whose patient portals may alert you to tests you’re due for. You can also remind yourself to schedule annual tests by using a milestone every year, like your birthday or the start of the new year. If you’re not sure whether you are due for a screening, the Women’s Preventive Services Initiative has a helpful list you can review with your doctor.

Your primary care physician should also inform you when it’s time, but that might not be the case if you use your gynecologist for primary care. “Things like the need for a colonoscopy and routine blood work that are outside a gynecologist’s scope can easily be missed,” Duah cautions. Let your gynecologist know you don’t have another doctor and request prescriptions for tests that don’t involve your reproductive organs.

Because screens are considered preventive, insurance coverage varies. It’s best to check with your insurance company before you make an appointment. You can also research whether your community offers any of these tests discounted or for free.

So what screenings should you be getting? Here are a dozen essential screenings women should take.

1. Check Your Blood Pressure
High blood pressure, also known as hypertension, is one of the key risk factors for cardiovascular disease, the leading cause of death in women, according to the Centers for Disease Control and Prevention (CDC). That’s why the American Heart Association (AHA) recommends regular blood pressure screenings with a simple test using a cuff around your arm to measure the force of blood through your vessels.

This screening should start at age 20, the AHA recommends. If your blood pressure is below 120/80 millimeters of mercury (mmHg), which is the ideal reading, you can have it checked at least once every two years until age 40, then annually after that. If it’s higher, you may be asked to have it checked more often.

Because some people get nervous during an office blood pressure test, which may cause higher than average readings, the United States Preventive Services Task Force (USPSTF), an independent group of medical experts, recommends confirming these readings with tests at home or other locations before determining whether treatment is needed.

2. Test Your Blood Sugar
According to the 2022 American Diabetes Association (ADA) recommendations, adults without risk factors for diabetes should be screened for prediabetes and type 2 diabetes starting at age 35, instead of age 45 as was previously recommended.

The ADA also says women who are planning to become pregnant should get screened before they conceive or, for unplanned pregnancies, at their first prenatal visit. Pregnant women should additionally be screened for gestational diabetes between 24 and 28 weeks of pregnancy.

For people who are overweight or obese, and therefore at increased risk of diabetes, the U.S. Preventive Services Task Force recommends that people from 35 to 70 get screened at least every two years until age 40. Those with readings indicating prediabetes should be referred for important lifestyle interventions.

Diabetes screens are blood tests, and there are three that are effective. One is a nonfasting test called hemoglobin A1C, or A1C, which measures your average blood sugar over the past two to three months. Other screens involve testing blood sugar after an overnight fast or a glucose test that measures blood sugar after you drink a sugary substance.

3. How Much Fat Is in Your Blood?
A lipid panel is a fasting blood test used to assess levels of cholesterol and triglyceride, blood fats that indicate your risk for heart disease or stroke. Total cholesterol is determined by adding the two cholesterol numbers, HDL (the healthier cholesterol) and LDL, along with 20 percent of your triglyceride level, according to the American Heart Association. The group notes that normal ranges are less important than overall cardiovascular risk, in which lipid levels are considered along with factors such as blood pressure and other medical conditions, which can be found on a risk calculator.

If you’re age 20 to 65, you should have your cholesterol measured at least once every five years, says the National Institutes of Health — more often if you are at high risk of heart disease. Those 65 and older should test their cholesterol annually.

4. Pap Smears
You may remember the days when women got annual Pap smears — a test in which a small brush is used to remove cells from around the cervix. But better understanding of how cervical cancer develops and improved testing for the human papillomavirus that causes this cancer mean annual screening is unnecessary now, Duah notes.

Current guidelines from the American College of Obstetricians and Gynecologists recommend that women of average risk get their first screen at 21, with a basic screen every three years until age 30. After that and until age 65, women can continue that schedule.

Or, they can instead have either a standalone test for HPV or a combined HPV and basic cytology test every five years. Women older than 65 who have had prior negative screenings do not need any Pap smear screens.

5. Get Your Breasts Checked
A mammogram, which screens for breast cancer, involves compressing the breast between plates so that X-ray images of the breast tissue can be captured. There has long been disagreement about when and how often a woman should have this test, given that the risk for breast cancer increases as you age, and that false positives from frequent screening can cause some harm.

The most recent guidelines from the USPSTF recommend that women start this screen at age 50 and continue to have one every two years until age 74, the age range when the tests deliver the most benefit. Those 40 to 50 who want to be screened should talk to their physician, the group notes. (The USPSTF is in the process of reviewing and potentially updating this guidance.)

Meanwhile, the American Cancer Society (ACS) says that women should start annual screenings at age 45, and can then switch to a biannual mammogram at age 55. Those 40 to 45 should have the option to screen if they desire, according to the ACS. If you have a family history of the disease, or other concerns, talk to your doctor about the right screening schedule for you.

6. Our Bones Get Weaker as We Age
Women should screen for the bone-weakening disease osteoporosis with a bone density test starting at age 65. Those with risk factors for osteoporosis, such as a low body weight or parental history of fractures, should talk to their doctor about getting screened earlier. Here, too, the USPSTF notes that this recommendation is under review.

A bone density screen is called a dual energy X-ray absorptiometry, or DEXA scan. You lie on a table while a low-dose X-ray machine captures images of your bones. Although X-ray levels are low, this test does expose a person to some radiation.

7. Colon Cancer Is on the Rise
In 2018, the American Cancer Society revised its screening guidelines to recommend that people of average risk for colon cancer have their first screen at age 45 rather than 50. The age was lowered because studies showed that incidence of colorectal cancer “was increasing at alarming rates in younger people,” says Laura Marakoff, DO, the senior vice president of prevention, early detection, and survivorship at the ACS.

Regular screens should continue until 75 (or sometimes 85, depending on the person’s overall health and life expectancy). People at increased risk, such as those with a family or personal history of colon cancer or a history of inflammatory bowel disease, should talk to their doctor about screening earlier than 45.

There are a number of ways to screen for colon cancer. No test is better than the other, Dr. Marakoff says, with your choice primarily based on personal preference.

Options include:

Stool-based tests like the highly sensitive fecal immunochemical test (FIT) or highly sensitive guaiac-based fecal occult blood test (gFOBT), done once a year
Multi-targeted stool DNA (mt-sDNA) (such as Cologuard) every three years
Visual exam of the colon and rectum with CT colonography (virtual colonoscopy) or with flexible sigmoidoscopy (FSIG) that examines the lower colon, done every five years
Colonoscopy, in which the entire colon is examined, once every 10 years

8. Sexually Transmitted Diseases
All sexually active women 24 and younger should be screened at least annually for chlamydia and for gonorrhea, and additional testing should be done for all people of any age who have new sex partners or are otherwise at risk, the USPSTF says.

Adolescents and adults ages 15 to 65 should also be screened for the human immunodeficiency virus (HIV), the task force says.

How often these screens should be repeated depends on a person’s risk. For example, HIV tests should be repeated whenever you have sex with someone who’s HIV status is unknown.

9. How Is Your Mental Well-Being?
Some 1 in 10 women suffer from depression each year, and 1 in 8 experience postpartum depression, according to the Centers for Disease Control and Prevention (CDC). “In primary care, we believe mental and emotional health are just as important as physical health,” Duah says. That’s why many doctors administer short questionnaires to screen for common mental-health conditions.

One test is the patient health questionnaire 9, or PHQ-9, which screens for depression by asking nine basic questions about your mood.

Another common screen is the generalized anxiety disorder assessment (GAD-7), which can reveal signs of this common anxiety disorder.

10. Smoking and Lung Cancer
Regular smokers between 50 and 80 years old should be checked for lung cancer once each year, according to the CDC. This applies to anyone with a history of smoking on the order of one pack a day for 20 years or two packs a day for 10, and who either currently smokes or has quit within the past 15 years.

Lung cancer screens are done with low-dose computed tomography (low-dose CT or LDCT), where a specialized X-ray machine takes detailed images of the lungs.

11. Check Your Skin
According to the MD Anderson Cancer Center, regular skin checks increase the chance you will find skin cancer earlier, when it is easier to treat. That’s why the American Cancer Society recommends that women examine their skin every month at home. Carefully inspect the skin all over your body, looking for any new moles, blemishes, or changes to existing moles, which can be early signs of skin cancer.

If you are at increased risk for skin cancer, or have a family history of it, the American Academy of Dermatology suggests you talk to your doctor or dermatologist about how often you should have an in-office exam.

12. Get a Yearly Dental Checkup
Bacteria and inflammation in your mouth have been found to play a role in several diseases, including heart disease and pneumonia, according to the Mayo Clinic.

That’s why all adult women need regular dental checkups, according to the American Dental Association. These regular dental checkups involve cleaning and examining the teeth, along with X-rays as needed, to spot early signs of decay and other problems.