The Five Health Screenings Every Woman Needs

Prevention is the best medicine and health screenings are key to making sure your health is on the right track. For women, these screenings can help detect certain cancers earlier and in more treatable stages, make sure your bones are healthy, monitor for heart disease — the number one killer of women in the United States — and colorectal cancer. 

Here's a list of the top five screenings every woman should consider for disease prevention, including what age these tests should begin, what the tests entail and how they are effective in keeping you healthy. 

1. Pap Smear and HPV tests

Cervical cancer often has no symptoms in its early stages, when it's the most treatable. There are two tests that are crucial to detecting cervical cancer in women: A Pap test, which is used to find abnormal cells on the cervix, and an HPV test, which looks for signs of HPV infection on the cervix. These tests are done by inserting a speculum into the vagina and then a small brush is used to take samples of cervical cells. 

Women should begin receiving Pap tests beginning at age 21, regardless of past sexual history and it should be done every three years. For women 65 and older, Pap test may no longer be necessary based on previous history. 

Beginning at age 25, women should begin receiving HPV tests. Pap and HPV tests are often done together at the same appointment. It's recommended that even women who have been vaccinated for HPV continue to be screened as the vaccine is not 100% effective in combatting all strains. HPV is responsible for up to 97% of all cervical cancers, that's why using the recommended schedule for Pap and HPV screenings is so important, as these tests are designed to detect precancerous changes before you have symptoms. 

While it's common to feel some discomfort during these tests, there are ways to help make the test more comfortable — from taking an over-the-counter pain medication ahead of your appointment, to urinating before the exam to help relieve the sensation of pressure, to asking that your provider use a smaller speculum. It's important that you speak to your provider about your concerns so that they can make you as comfortable as possible. 

For patients who experience pain, stress or anxiety during these exams, UC San Diego Health has an obstetrics and gynecology clinic that is nationally accredited to offer in-clinic moderate sedation for certain treatment options, such as minimally invasive gynecological, contraceptive and family planning procedures.

2. Mammograms

A mammogram is a type of X-ray exam used to detect early signs of cancer in the breast. Mammograms are the best tool for detecting breast cancer early for the most optimal outcomes. 

UC San Diego Health recommends that all women 40 and older, as well as women at high risk of breast cancer, get an annual routine mammogram and clinical breast exam. For women between the ages 40 and 45, your recommendations may be different depending on your risk factors and family history. The U.S. Preventive Service Task Force recommends annual mammograms for women up to the age of 74. From age 75 on, an annual exam may no longer be necessary but this should be discussed with your health care provider. 

Some women — because of family history, a genetic tendency, or other factors — should receive more frequent screenings, screenings starting at an earlier age, or different kinds of tests. Talk with your doctor to find out if you fall into this category. For women who do fall into this category, UC San Diego Health offers genetic testing through our family cancer genetics program.

UC San Diego Health is recognized as an American College of Radiology (ACR) Designated Comprehensive Breast Imaging Center. This designation recognizes our skill in using screening, diagnostic and interventional radiology techniques to improve breast care. Fewer than 6% of all breast imaging centers in California have earned this recognition.

3. Heart Health Screenings

Heart disease continues to be the number one cause of death among women in the United States. In order to prevent heart disease, women should receive annual screenings for blood pressure, cholesterol and blood glucose levels as diabetes can increase risk for cardiovascular disease. 

These tests are usually recommended beginning at age 18 and the frequency of testing can vary depending on risk factors, such as family history, and lifestyle factors, such smoking tobacco or obesity. It's important that you discuss your risk with your health care provider about making a plan to stay on top of your heart health.

4. Bone Density 

Keeping your bones healthy is important as it can minimize risk for fractures. To help prevent osteoporosis and further decline in bone mineral density, it is important to keep active by doing weight bearing exercises, get enough calcium and vitamin D in your diet, limit alcohol intake, and refrain from smoking. 

Because women experience menopause, osteoporosis is more common in women than in men, which is why bone density tests are recommended for all women beginning at age 65. For women with risk factors for osteoporosis, such as family history, history of fracture, or certain medical conditions, such as rheumatoid arthritis or diabetes, your doctor may recommend DXA earlier.

Bone density is measured with a DEXA or DXA (dual-energy X-ray absorptiometry) scan — a type of low-dose X-ray. This non-invasive test is performed to diagnose osteoporosis in the hips and spine. 

If you have experienced bone loss, UC San Diego Health offers the latest treatments and our bone health team includes researchers at the forefront of new discoveries. They are experts in tailoring osteoporosis therapy to meet your individual needs.

5. Colonoscopy

Colorectal cancer is one of the top five cancers in the United States, and while occurrences in those over the age of 65 are dropping, there has been an alarming rise in people under the age of 50. Colon cancer is the third most common cancer in the U.S. and the second leading cause of cancer death. Colon cancer develops from small growths called polyps, which over many years can change into cancer. 

The American Cancer Society recommends screening for adults beginning at age 45 and continuing through age 75. For people with certain risk factors, such as family history, beginning screenings at an earlier age may be recommended.

The gold standard test for colorectal cancer is a colonoscopy, which is an endoscopic procedure using a colonoscope to examine the colon for polyps and other abnormalities. After you are prepped and sedated, a thin flexible tube with a camera attached to it is inserted through the anus and passed through the length of the large intestine to where it joins the small intestine.

During this procedure, the doctor can remove any polyps you might have and take tissue samples as needed. Frequency of additional screenings are based on findings of earlier tests — up to ten years for average risk or between three to seven years depending on number of polyps found during the test. 

UC San Diego Health patients have access to comprehensive colorectal cancer screening and care that combines nationally recognized clinical expertise with leading-edge research and a patient-centered approach. As part of the region's only academic medical center, UC San Diego Health physicians are also helping shape national screening strategies to improve early detection and save lives.