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Screening
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Who needs it
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How often
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Alcohol misuse
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All adults
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At routine exams
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Blood pressure
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All adults
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Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:
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Every 2 years if blood pressure reading < 120/80 mm Hg, or
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Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg
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Breast cancer
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All women*
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Yearly mammogram and clinical breast exam*
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Cervical cancer
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All women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious precancer
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Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years.
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Chlamydia
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Women at increased risk for infection
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At routine exams if at risk
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Depression
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All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
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At routine exams
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Diabetes mellitus, type 2
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Adults who have no symptoms and have sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg
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At least every 3 years
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Gonorrhea
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Sexually active women at increased risk for infection
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At routine exams if at risk
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HIV
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Anyone at increased risk for infection
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At routine checkups
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Lipid disorders
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All women age 45 and older at increased risk for coronary artery disease
For women ages 19 to 44, screening should be based on risk factors1; discuss with your health care provider
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At least every 5 years
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Obesity
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All adults
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At routine checkups
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Syphilis
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Women at increased risk for infection
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At routine exams if at risk
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Tuberculosis
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Anyone at increased risk for infection
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Check with your health care provider
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Vision
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All adults2
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Baseline comprehensive exam at age 40; if you have a chronic disease, check with your health care provider for exam frequency
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Counseling
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Who needs it
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How often
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Breast cancer, chemoprevention
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Women at high risk
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When risk is identified
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BRCA mutation testing for breast and ovarian cancer susceptibility
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Women with increased risk
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When risk is identified
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Diet, behavioral counseling
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Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease
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When diagnosed
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Tobacco use and tobacco-related disease
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All adults
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Every visit
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Immunization
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Who needs it
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How often
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Tetanus/diphtheria/pertussis (Td/Tdap) booster
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All adults
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Td: every 10 years
Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years
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Chickenpox (varicella)
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All adults ages 19 to 49 who have no documentation of previous infection or vaccinations
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Two doses; the second dose should be given at least 4 weeks after the first dose
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Measles, mumps, rubella (MMR)
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All adults ages 19 to 49 who have no documentation of previous infection or vaccinations
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One or two doses
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Flu vaccine (seasonal)
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All adults
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Yearly
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Hepatitis A vaccine
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People at risk3
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Two doses given 6 months apart
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Hepatitis B vaccine
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People at risk4
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Three doses; the second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)
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Meningococcal
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People at risk**
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One or more doses
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Pneumococcal (polysaccharide)
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People at risk5
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One or two doses
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