John Browning, MD

Many women work hard to take care of their family, job, and many other responsibilities and may not take the time to prioritize their own health. Research shows over 40 percent (or 70 million women) skip or delay important preventive health screenings for cancers, heart disease, sexually transmitted infections, and other medical conditions. These vital screenings can catch a variety of medical conditions early and are important for a woman’s overall health and well-being.

Women report skipping or delaying health screenings for several reasons including having anxiety about medical tests, concerns about pain, the cost of a screen, and a lack of awareness and time.  Recommended screenings for “women only” include those for cervical and breast cancer, sexually transmitted infections including HPV (human papillomavirus), and osteoporosis. Other recommended screenings for both men and women include colorectal cancer, skin cancer, diabetes, heart disease, and cholesterol.

Many women, especially younger women, are at higher risk for missing preventive health screenings. They may look for health information online but may not know what to look for or find information that may not be in line with national screening guidelines. Underserved populations of women may not have the means to pay for health care and skip screenings completely.

It’s important for women of all ages to advocate for themselves and their health. Finding a primary health care provider and gynecologist you trust and can talk to openly and honestly can help decrease anxiety, provide clarification, and answer any questions you may have.

An annual well-woman visit is recommended each year and includes a physical exam, discussion of preventive health screenings and vaccines, time to review and discuss any reproductive issues, and set health goals. This is a time to talk to your provider or gynecologist about any reproductive concerns in all phases of life, including irregular menstrual cycles, any pelvic pain or discomfort, sexuality, hormones, sexually transmitted infections, fertility, perimenopause, and menopause. Whether it’s a routine or well-woman visit, women need to review and discuss preventive health screenings and schedule screenings when appropriate.

Breast Cancer

Breast cancer affects one out of eight women. Breast self-exams and annual mammography testing helps with early detection, treatment, and better outcomes.

An annual mammography screen is recommended for women ages 40 and older. If breast cancer runs in your family, talk to your provider to discuss earlier mammography testing as needed or indicated.

It is recommended for women to begin a monthly breast self-exam by age 20 and continue throughout their lifetime. Pick a day each month, two to five days after the menstrual cycle, or the same day each month during and after menopause for your breast self-exam. Get to know your breasts and what feels normal. If you notice anything abnormal, contact your health care provider.

For instructions on how to correctly perform the breast self-exam, visit breastcancer.org/screening-testing.

Cervical Cancer Screen for Human Papillomavirus (HPV)

HPV is a highly contagious virus and the most common sexually transmitted infection (STI). The good news is ninety percent of the time, the immune system clears HPV. If the virus does not go away, it can cause genital warts and is the primary cause of cervical cancer as well as other types including mouth, throat, and anal cancers.

The cervical cancer screen includes two types of tests: a pap smear, where cells are taken from the cervix and biopsied for precancerous cells, or a swab for HPV strains that could lead to cancer. Both tests are often completed at one time, but one or the other can be used for cervical cancer screening with the following recommended screening guidelines:

• First HPV screening at age 21
• Screen with a pap smear or HPV test every three years from ages 21-29
• For ages 30-64, screen for HPV every five years with an HPV test and/or pap smear
• No further screening for HPV is needed for ages 65 and older

An FDA approved self-collection HPV screening test is recommended for those who are not able to complete a pelvic exam.

Along with HPV screenings, the HPV vaccine can greatly reduce the risk of developing cervical cancer. The Centers for Disease Control recommends all girls and boys receive the vaccine at age 11 or 12 and up to age 26. If you’re between the ages of 27-45, the HPV vaccination is also appropriate for select patients and should be individually discussed with your health care provider or gynecologist.

If either HPV screen is positive, a procedure called a colposcopy is the next step to take a closer look and rule out any abnormalities.

Osteoporosis Screening

Osteoporosis is a medical condition that causes bones to become weak and easier to break especially in the wrist, hip, or vertebrae in the spine. Many women experience no symptoms until a bone breaks. Risk factors include being a woman, being particularly slender, age, family history, certain medications and medical conditions, and lifestyle factors including a diet low in calcium and vitamin D starting in childhood, alcohol intake, smoking, and low physical activity.

The screening for osteoporosis involves completing a bone density test starting at age 65 and earlier if you have risk factors. Talk to your provider about when to screen for osteoporosis.

Colorectal Cancer

The screen for colon cancer is a colonoscopy and is recommended at age 45. Follow-up screening times are determined after the first screen, typically after 10 years if no polyps are found.

Skin Cancer

The American Cancer Society recommends people between ages 20-40 get a professional skin exam every three years and annually after age 40. Monthly skin self-checks are recommended for all ages. For more information on how to do a skin self-check, visit skincancer.org/early/detection/self-exams.

Diabetes and Cholesterol

Blood sugar and cholesterol screens are recommended annually, so don’t miss your annual wellness exam and blood work. Annual exams are an important part of routine and gynecological care for women. Your provider can also discuss any other needed screens for heart disease or other individualized screens based on family history or symptoms.

Other Preventive Health Screenings

Discuss other preventive health screenings with your health care provider. Some people may need screenings earlier or more often depending on individual risk factors.

Women of all ages need to prioritize their health, and preventive health screenings are an important part of self-care. The partnership with your provider can help you make the best decisions for your health. If you don’t have a provider, ask friends and family members for recommendations. Advocate for yourself by setting an appointment and writing out questions you want to discuss. If you’re dealing with anxiety, take a friend or family member with you. Talk frankly with your provider and make decisions together about what works best for you.