Screening, immunizations, physicals, Oh My! When and how often adults should schedule appointments

Dr. Rachel Hartline is a family practice physician at Upland Hills Health clinics in Spring Green, Highland and Montfort. You can learn more about Dr. Hartline here: https://www.uplandhillshealth.org/our-providers/dr-rachel-hartline/

You have the power to take care of your body! There are many different prevention methods for you and your loved ones to make part of your health regimen. Depending on who you ask, you may see different recommendations for these practices, but I base my recommendations on the work of the U.S. Preventive Services Task Force (USPSTF), a national organization tasked with weighing the risks and benefits of preventive healthcare methods without input from financial stakeholders like insurance companies, drug companies, and medical device makers, and the American Academy of Family Physicians.

Here is a list of some medical tests, screenings, and immunizations I recommend. Along with these recommended tests, screenings, and immunizations, you should also have a wellness visit with your primary doctor every 1-2 years, to help determine your personal needs and risk factors.

For Women

• Cervical Cancer Screening: A pap smear every 3 years for all women age 21-29, and a pap smear and HPV test every 5 years for women aged 30-65.
• Chlamydia Test: Every year for sexually active women through the age of 24. Studies have shown that chlamydia is more common in individuals less than 25 years old, and this especially impacts young women as they can develop chlamydia and have no symptoms, but due to inflammation from the infection develop infertility! A discussion about screening for sexually transmitted infections in all sexually active individuals is worthwhile, but this practice has a strong recommendation for women <25 because they are the population with the biggest risk.
• Mammogram: Talk with your doctor about when it is appropriate for this screening to take place. After 50 years of age is when most women are encouraged to get their first, base mammogram. Some women choose to start earlier, around 40 years old, depending on their individual risk factors– but mammograms in this age group are worth a discussion with your doctor because denser breast tissue can make screening less accurate. I recommend mammograms every 2 years as a rule, though some women can benefit from yearly mammograms depending on their risk factors and their individual weighing of the risks and benefits of screening. Some women choose to stop screening at age 75– but again this is an individual decision worth discussing with your doctor.
• Bone Density Test: Recommended for women at average risk age 65 and older, every 3-5 years. Women who have long-term use of prescribed steroids (like prednisone) may benefit from earlier screening. Other risk factors include tobacco use and drinking alcohol more than 2 standard drinks/day as well as family history, but generally these risk factors are minor and don’t affect the age at which we recommend the first screening.

Men

• Prostate Cancer Screening: Discuss this with your doctor– we have discovered that the PSA test is less accurate than we used to think in diagnosing prostate cancer, but it can be useful for certain men.

Both (Men & Women)

• HIV Test: It is important to have this test done at least once in your adulthood
• Blood Pressure Check: Unless other issues have developed at a younger age, it is recommended to have your blood pressure checked by a physician every 2 years if you’re 64 and younger and every year if you’re 65 and older.
• Cholesterol Check: Unless other issues have developed at a younger age, it is recommended to start cholesterol checks beginning at the age of 35 in average-risk men and 45 in average-risk women. This check should be done every 5 years.
• Colon Cancer Screening: Talk with your doctor on what the best option for you would be. We recommend starting screening at age 50 unless you have additional risk factors, but the American Cancer Society recently released a recommendation that people begin having colonoscopies at age 45.
• Hepatitis C Test: If you were born between the years 1945 and 1965, it is recommended to have this screening done at least once in your adulthood.
  Vision and Hearing Checks: At least once a year for men and women 65 and older.

Immunizations

• Tetanus-Diphtheria: Every 10 years you should receive a booster shot. For patients who were immunized as children, their first adult Tetanus shot will be necessary at around age 21-22.
• Flu Vaccination: This should be done every year.
• Shingles Vaccination: For men and women 50 and older – 2 dose series (or a single dose if you start at age 60). There is new shingles vaccine, Shingrix, released in the past year or so that is much more effective than the one that was previously available so even if you have been immunized in the past it is worth pursuing the new shingles shot. Even if you have had shingles in the past, the shot can help to prevent a recurrence.
• Pneumococcal Vaccination: Two different vaccinations are recommended, 1 year apart. These are recommended for patients aged 19-64 with high risk and for all patients 65 and older.