Health Care Screening
Screening visits ages 20-40 for at least every 2 years. Over 40, every year
Initial visit only (yearly in selected patients)
Including diet and exercise, smoking and alcohol use, noise or pollutant exposures
Each Screening Visit
Physical Exam Procedures
Complete – Initial visit and yearly in selected patients
Weight – Each screening visit
Blood Pressure, Pulse and Respiration – Each screening visit
Eye Exam – Each screening visit (selected patients)
Hearing Exam – Each screening visit (selected patients)
Skin Exam – Each screening visit
Breast Exam – Each screening visit
Pelvic Exam (by Internist or Gynecologist) – Each screening visit – age over 50
Rectal Exam (check stools for blood) – Each screening visit – Age over 40
Tonometry (Glaucoma check) – Each Screening Visit – age over 40 every 2 years (dependent on risk)
Dental Exam – Each Screening Visit
Proctoscopy – (Flexible Sigmoidoscopy/Colonoscopy/CT Colongraphy) – Every 10 years after age 40-50 (more often in selected patients)
Pap Smear – Every 2-3 years (after 2 negatives, 1 year apart) (up to age 65-70 after 3 negative exams)
Stool for Occult Blood – Each screening visit over age 40
Complete Blood Count (CBC) – Every Screening Visit
Chemistry Screening – (includes Urinalysis, Cholesterol-lipid screen, Electrolytes, Kidney function, Liver function, Calcium and Phosphorous, Uric Acid, Blood Sugar)
Thyroid Profile (TSH) – Every 2-4 years over 40
PSA – Every year (Selected Males age 50 to 70)
TB Skin Test (PPD) – High Risk Groups
HIV, RPR – High Risk Groups
Hepatitis C Antibody – High Risk Groups
EKG, Cardiac Echo
(CT Scan/Calcium Score) – Baseline at age 50 (Selected Patients)
Exercise EKG (Treadmill Stress Test)
(Myocardial Perfusion Scan/Echo) – High Risk Groups
Bone Density (DEXA) – High Risk Groups, Baseline at age 50-60 (Females, Selected Patients) (Baseline at age 70 (Males)
Carotid/Abdominal Ultrasound – Selected High Risk Groups
Breast, Testes Self-Exam – Initial screening visit
Use Sun Screen and Avoid Sun – Each screening visit
Influenza – Every year
DPT (Diptheria, Pertussis, Tetanus) – Every 10 years
Pneumococcal Vaccine – Over age 60 or high risk groups (every 5-10 years)
Measles, Mumps, Rubella – Full course if non-immunized
Zostavax (Shingles) – Over age 50-60 in patients with a history of Chicken Pox
Hepatitis A and B – High Risk Groups/Travel
Typhoid, Yellow Fever – Highly Selected Groups – Travel
American Cancer Society Recommends
(1) Women 20 and over, and those under 20 who are sexually active, should have a PAP Test at least every 3 years, after 2 initial negative tests a year apart.
(2) Women 20 – 40 should have a pelvic examination as part of a general physical examination every year and women over 40 every 1 – 3 years. (after menopause every 1 – 5 years)
(3) Every woman should have a pelvic examination and PAP test at menopause. Those at high risk of endometrial cancer should also have an endometrial tissue sample examined. High risk is defined as having a history of infertility, obesity, failure of ovulation, abnormal uterine bleeding, or estrogen therapy.
(4) Women over 40 should have a mammogram every year. Women under 40 should consult their personal physicians about the need for mammography in their individual cases. All women should have a breast baseline mammogram between the ages of 35 – 40.
(5) Women 20 – 40 should have a breast physical examination every three years, and women over 40 should have a breast physical examination every year.
(6) All women over 20 should perform a breast self-examination monthly.
(7) Men and women over 20 should have a stool gualac slide (test for occult blood) every year.
(8) Men and women over 40 should have a sigmoldoscopic examination every five to ten years. (colonoscopy screening in selected patients)
(9) Men and women over 40 should have a digital rectal examination every year.
(10) Selected men over age 50 should have a PSA in addition to a digital prostate exam.
(11) Men and Women over age 20 should have a full body exam annually – selected men and women.
(12) The role of CT screening for cancer is not yet defined