Ladies A Moment: 10 Health Screenings That All Women Need
Medically reviewed by Carmen Fookes, BPharm. Last updated on July 12, 2022.
Cervical Cancer Screening
Cervical cancer once use to kill more women in the U.S. than any other cancer. But since Pap smears and HPV testing have become commonplace, the death rate from cervical cancer has significantly decreased.
Pap smears (short for Papanicolau smears) collect cells from the cervix (the opening of the uterus), which are then stained and examined under a microscope for the presence of abnormal cells. Pap smears can pick up both precancerous and malignant (cancerous) cells.
HPV testing looks for the presence of high-risk HPV-virus types, such as HPV16 and HPV18, that cause 70% of cervical cancers.
The American Cancer Society's 2020 guidelines recommend:
- Individuals with a cervix initiate cervical cancer screening at age 25 years with primary HPV testing every 5 years through to age 65
- If primary HPV testing is not available cotesting (HPV testing in combination with cytology) should be used every 5 years or cytology alone every 3 years
- Individuals with a cervix who are older than age 65 years, with no history of cervical intraepithelial neoplasia grade 2 or greater in the past 25 years, and no history of a negative screening test within the past 10 years, do not need to undergo further cervical cancer screening
- Cervical cancer screening may be discontinued if life expectancy is limited.
But despite the widespread availability of testing and its proven effectiveness at detecting invasive cervical cancer before it's too late, more than 4000 people in the U.S. still die from this disease every year. Up to 93% of cervical cancers are thought to be preventable.
Breast Screening Detects Early Cancer
We all know somebody who has had, or now has, breast cancer. Perhaps it’s your Mom, your aunt, your sister, or a friend. Breast cancer kills over 43,000 American women each year but chances of survival are greatly increased if the cancer is detected early.
Recommendations for regular mammograms vary; for example the USPSTF recommend routine biennial screening in women aged 50 through 74 years at average risk of breast cancer; whereas the American Cancer Society recommend annual mammograms start at age 45.
This does not mean women cannot start screening at a younger age if they want to, after weighing up the risks versus benefits. There is good cause for women with a strong family history, genetic tendency, or history of radiation therapy to the chest to have earlier mammograms. You should also be aware of the normal look and feel of your breasts and report any nipple or breast changes to your doctor.
Having Sex? Then Get A Chlamydia Test
Chlamydia is a bacterial infection that is acquired during sex. It is often referred to as a “silent” sexually transmitted disease (STD), because up to 75% of women infected with chlamydia show no symptoms. Left untreated, it can lead to pelvic inflammatory disease and infertility.
The CDC recommends all sexually active women aged 25 and younger should be tested yearly for chlamydia. Testing is also recommended in women who are pregnant and in older women with a new partner or who are not in a mutually monogamous relationship.
A urine sample is taken for testing.
HIV: Numbers Diagnosed On The Decline, But Do You Know Your Status?
6,999 women were diagnosed with HIV in 2019 (the most recent statistics available) and most of the new diagnoses were attributable to heterosexual contact. Although African American women have achieved the largest decrease in diagnosis rate, they are still disproportionately affected by HIV.
Testing for HIV is quick and easy. HIV testing is available through your healthcare provider, medical center, some pharmacies, medical clinics, substance abuse treatment programs, hospitals, Title X Family Planning Clinics, as well as at many community-based organizations.
A list of HIV testing sites searchable by zip code is available on the CDC HIV testing information page, or you can call 800-CDC-INFO (800-232-4636) for a list of free testing sites in your area. Home testing kits are also available and every year a National HIV Testing Day is on June 27th.
Being aware of your HIV status could save your life. Treatments for HIV are much more effective if started early, and make it possible to live a long and healthy life with HIV. If you are infected, you can take steps to help reduce the spread to others, including your partner or baby. If you test negative, but are still at risk of contracting HIV, you can take advantage of important preventive measures (for example, pre-exposure prophylaxis with Truvada or Descovy) to remain HIV-free.
The CDC recommends, as a routine part of your medical care, that all adolescents and adults get tested for HIV at least once. Those at higher risk (such as injection drug users or women who are partners of bisexual men) should get tested more frequently.
No Energy? You May Be Iron Deficient
Iron deficiency is the most common nutritional deficiency in the world and reasonably prevalent among women, teenage girls, children, and those with iron-poor diets. Women who have heavy periods, exercise a lot, or who are pregnant or breastfeeding are particularly at risk.
Iron deficiency is also more common in those who have undergone major surgery or suffered from physical trauma, people with gastrointestinal disorders such as Celiac disease, Crohn's disease, or Ulcerative colitis, peptic ulcer disease, vegetarians or vegans, and in children who drink a lot of milk (milk not only contains little iron but it can reduce iron absorption). Although the risk of iron deficiency decreases after menopause, women can still become iron deficient because of iron malabsorption or gastrointestinal bleeding.
Iron is used to make blood and helps in brain development. Although some women who are iron deficient feel tired or lack energy, many have no symptoms. If iron deficiency is left untreated, it can progress to iron deficiency anemia - a blood condition with more pronounced symptoms such as shortness of breath, chest pain, pale skin, or unusual food cravings (such as ice, dirt, or starch).
Ask your doctor for a blood test that measures the amount of iron in your blood if you suspect you may be deficient.
Test For Diabetes If You Are Overweight, Have High Blood Pressure, or are Over 45
Type 2 diabetes affects over 15 million American women. Diabetes is a condition where glucose stays in the blood instead of being taken up into cells and utilized as energy. Most people do not have any symptoms initially, but if left untreated, high levels of blood sugar can cause damage to the heart, kidneys, eyes, and nerves.
If you are over the age of 45 you should be tested for type 2 diabetes at least every 3 years; especially if you are overweight or obese. Younger women with a family history of diabetes or with other risk factors such as high blood pressure or cholesterol; or excess weight, should begin testing at a younger age.
Love Your Heart And Go Red For Women
Heart disease is the leading cause of death of women in the United States. Signs of heart disease, particularly a heart attack, are not always as clear cut as movies may lead you to believe.
Some women feel an uncomfortable pressure, pain, squeezing, or fullness in the center of their chest that may persist for several minutes or go away and come back. Others may feel pain in their back, neck, jaw, stomach, or one or both arms. Research shows as many as half of all heart attacks may be silent or barely noticeable, and include nonspecific symptoms such as tiredness, nausea, or shortness of breath.
The best way to learn about your risk for heart disease is to schedule an appointment with your doctor or healthcare provider. Risk is calculated on blood pressure readings, cholesterol tests, presence of diabetes, weight and level of activity. The risk of heart disease is also higher in people who smoke or who have family members with the condition.
But it's never too late to improve your heart health. Stop smoking if you smoke and increase your level of physical activity - start slowly at first if you have been inactive for some time and include some strength-training using weights. Modify your diet to include more vegetables and less snacks and sugar-laden foods. Limit how much salt you eat.
Cholesterol Goodies And Baddies
When doctors talk about a cholesterol test, they are actually talking about a test that measures the different types of fat or lipids in your blood. Research has shown that certain fats and lipids are associated with a higher risk of heart attack or stroke.
The American Heart Association recommends: "Everybody aged 20 or older should have their cholesterol levels checked at least every four to six years as part of a cardiovascular risk assessment". Earlier and more regular testing is recommended for people already diagnosed with heart disease.
By themselves, cholesterol levels don't mean much, but if they coexist with other risk factors for heart disease, such as a family history of cardiovascular disease, high blood pressure, or smoking, then they do. Only once all these factors are taken into consideration will doctors decide on whether treatment is needed.
Colorectal Cancer Screening Can Save Your Life
In 2022, the American Cancer Society estimates more than 150,000 Americans will develop colorectal cancer with about 52,580 people dying from the disease. Women have a lifetime risk of approximately 4%. While the risk for women is slightly less than that for men (lifetime risk of colorectal cancer is 4.3% for men), that risk can be further reduced with regular screening.
The USPSTF recommends screening for colorectal cancer starting at age 45 and continuing through to age 75; earlier screening is recommended for people with inflammatory bowel disease (such as Crohn's disease or Ulcerative colitis), a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome), or who have a close family member who has had colorectal polyps or colorectal cancer.
Screening may involve either a test that detects blood in your stool (called a fecal occult blood test), or a procedure such as a sigmoidoscopy or colonoscopy that inserts a narrow, hollow, flexible tube up your bottom to look at the inside lining of your bowel. Screening increases the chance that cancer will be detected early, while it is still treatable, and also allows for the removal of polyps (small growths that protrude from the bowel wall), which are precursors to cancer.
Strong Bones Are Good Bones
Our bones are continually being broken down, remodeled and rebuilt. As we age, the breaking-down part of the process starts to overwhelm how much building-up the bones can do and as a result our bones start to become brittle and weak. Deficiencies of vitamin D, minerals such as calcium and phosphorous, and declining hormone levels in women accelerate this process. Women are four times more likely than men to develop osteoporosis (a progressive disorder in which the bones become fragile and brittle).
Bone density testing is usually done using a DXA scan, which measures how much calcium and other types of mineral are present in a specific area of your bone. Most often, the hip or spine is tested; however, testing can also be done on the radius bone in the forearm. Some health fairs or medical offices use peripheral tests (such as a pDXA, QUS, pQCT) to identify which patients would benefit from a DXA. These measure bone density in the lower arm, wrist, finger or heel. However, these screening tests cannot accurately diagnose osteoporosis and the results are not comparable to those of a central DXA.
The National Osteoporosis Foundation recommends bone density testing in women aged 65 and older, in those who break a bone and are over the age of 50, and in younger women with risk factors (such as smoking, previous fracture, prescribed prednisone) who are menopausal or postmenopausal. Doctors may also consider testing your bone density if an x-ray shows a breakage or bone loss in your spine, with persistent back pain, a height loss of an half inch or more within one year, or a decrease in your total height of one and a half inches.
- Cervical cancer statistics. CDC http://www.cdc.gov/cancer/cervical/statistics/
- What are the key statistics about breast cancer. American Cancer Society http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics
- American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. American Cancer Society http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs
- Chlamydia (chlamydia trachomatis genital infection) New York State Department Of Health https://www.health.ny.gov/diseases/communicable/chlamydia/fact_sheet.htm
- HIV/AIDS WomensHealth.gov https://www.womenshealth.gov/hiv-and-aids
- Iron deficiency anemia. American Society of Hematology http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx
- What Are the Signs and Symptoms of Iron-Deficiency Anemia? National Heart Lung and Blood Institute http://www.nhlbi.nih.gov/health/health-topics/topics/ida/signs
- Qamar K, Saboor M, Qudsia F, Khosa SM, Moinuddin, Usman M. Malabsorption of iron as a cause of iron deficiency anemia in postmenopausal women. Pakistan Journal of Medical Sciences. 2015;31(2):304-308. doi:10.12669/pjms.312.6462.
- Iron deficiency Anemia. Drugs.com https://www.drugs.com/mcd/iron-deficiency-anemia
- Understand Your Risks to Prevent a Heart Attack. American Heart Association https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack
- How to get your cholesterol tested. American Heart Association http://www.heart.org/HEARTORG/Conditions/Cholesterol/SymptomsDiagnosisMonitoringofHighCholesterol/How-To-Get-Your-Cholesterol-Tested_UCM_305595_Article.jsp#.Vz0yR5F96M8
- Colorectal Cancer: Screening. May 18, 2021. US Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
- Tests to detect colorectal cancer and polyps. National Cancer Institute http://www.cancer.gov/types/colorectal/screening-fact-sheet
- What is colorectal cancer. American Cancer Society http://www.cancer.org
- Fontham, ETH, Wolf, AMD, Church, TR, Etzioni, R, Flowers, CR, Herzig, A, Guerra, CE, Oeffinger, KC, Shih, Y-CT, Walter, LC, Kim, JJ, Andrews, KS, DeSantis, CE, Fedewa, SA, Manassaram-Baptiste, D, Saslow, D, Wender, RC, Smith, RA. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020: 70: 321- 346. https://doi.org/10.3322/caac.21628
- HIV and Women: HIV Diagnoses. July 21, 2022. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/group/gender/women/diagnoses.html
- Bone Density Exam/Testing National Osteoporosis Foundation https://www.nof.org/patients/diagnosis-information/bone-density-examtesting/
- Osteoporosis. Are you at risk? Osteoporosis Health Center http://www.webmd.com/osteoporosis/guide/osteoporosis-risk-factors
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.