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Screenings and Exams for Adults

These recommendations are established by the listed resources only and not by GEHA. The recommendations are intended as general guidelines only. Other resources may offer different recommendations. Please consult your health care provider to determine which screenings and exams you need. Be sure to check your GEHA Plan Brochure for coverage information on all screenings, exams and immunizations.

Recommended screenings & exams for adults age 19 and older

Physical examination, including height, weight, blood pressure and skin cancer screening, should be routine every 1 to 2 years.

Pap smear for cervical cancer screening

  • Sexually-active female adolescents and women over age 20 (regardless of sexual activity) should have an annual Pap smear. After three consecutive, negative, annual Pap smear tests, women who are celibate (not sexually active) or monogamous (have only one partner) and younger than 35 to 40 years of age may decrease Pap smear testing to every 2 to 3 years.
  • Women over the age of 40, women with multiple sexual partners and women who take oral contraceptives should have an annual Pap smear.
  • Women with a medical history of HPV (genital warts) should have a Pap smear every 6 months.

Breast self-examination (BSE) should be taught during adolescence and continued on a monthly basis throughout a woman's life.

Mammography - radiologic (X-ray) evaluation of the breast tissue

  • A baseline mammogram is recommended for women at age 40.
  • Mammograms should be repeated every 2 years for women between 40 and 50 years old, if the baseline test is clear.
  • An annual mammogram is recommended for women over 50.
  • A mammogram may be done at an earlier age or at more frequent intervals if problems are suspected or the woman is at increased risk (for instance, if a first-degree relative has had breast cancer).

Testicular self-examination (TSE) should be taught during adolescence and continued on a monthly basis throughout a man's life.

Prostate cancer screening

  • Prostate health should be evaluated by annual digital rectal examination for men over 40.
  • PSA (prostate specific antigen) may also be used as a test to screen for prostate cancer but it is not specific and may indicate benign growth of the prostate (benign prostatic hypertrophy) as a man gets older. Screening may begin earlier if there is a strong family history.

Cholesterol screening

A baseline total cholesterol measurement, as well as a measurement of bad (LDL) and good cholesterol (HDL), should be obtained for all adults between 18 and 20 years of age. If normal, the test should be repeated every 5 years. Individuals at higher risk, including children with a strong family history of hyperlipidemia, may be screened earlier and at more frequent intervals.

Hemoglobin A1C screening

  • A Hemoglobin A1C screening, which measures the blood sugars, should be performed at least twice a year if you have diabetes. The target for this screening should be below 7.
  • If you are 45 or older, and have a family history of diabetes, you should be screened every three years.
  • Other factors that can increase your risk for diabetes include a personal history of gestational diabetes, obesity, inactivity, high blood pressure or race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians and Asian Americans and Pacific Islanders are at particularly high risk for pre-diabetes and diabetes.
  • Seven percent of the U.S. population has diabetes. Hemoglobin A1C screenings can help lead an early diagnosis of diabetes, as elevated sugar levels may not always produce symptoms.

Colon cancer screening

In February 2009, the American College of Gastroenterology (ACG) came out with new guidelines for colorectal cancer screening. The ACG has grouped different colorectal screenings into cancer prevention and cancer detection. A colonoscopy every 10 years is the preferred cancer prevention test. Alternative cancer prevention tests include the flexible sigmoidoscopy every 5 to 10 years or a CT colonography every 5 years. ACG defines the fecal immunochemical test (FIT) as the preferred detection test, which should be completed annually. According to the American Cancer Society, annual screening using the FIT can reduce mortality rates from colorectal cancer by 33 percent.

  • A stool guaiac or other test for occult (hidden) blood in the stool should be done every year after age 50 (or sooner if there is a family history of colon cancer).
  • A flexible sigmoidoscopy is recommended every 3 years after age 50 (earlier or at more frequent intervals for individuals at higher risk); colonoscopy, which is probably a better screening test than flexible sigmoidoscopy, needs only to be repeated every 5 to 10 years if normal.
  • The FIT is a screening for human hemoglobin in stool that is simple and convenient. It is effective at detecting lower gastrointestinal bleeding as a non-invasive screening test for colorectal cancer detection, with an 87 percent for cancer, compared to a 54 percent sensitivity rate for a guaiac fecal occult blood test.

Blood pressure should be checked annually.

Weight should be checked annually unless there are notable weight losses or gains.

Dental examinations and cleaning should be routine, every 6 months or so.

Resource: U.S. National Library of Medicine, the National Institutes of Health (www.nlm.nih.gov)