Menopausal symptoms Exercise: discussion of program
Neck: adenopathy, thyroid Sleep disorders
Breasts, axillae Cardiovascular Risk Factors
Cervical cytology (may screen every 3 years after three consecutive Lifestyle negative test results if no history of cervical intraepithelial neoplasia 2 or 3, immunosuppression, human immunodeficiency virus infection (HIV), or diethylstilbestrol exposure in utero, or every 3 years after negative human papillomavirus DNA test and negative cervical cytology†
Colorectal cancer screening (beginning at age 50 years∗: Health/Risk Behaviors colonoscopy every 10 years [preferred])
Fasting glucose testing (every 3 years after age 45 years) Aspirin prophylaxis to reduce the risk of stroke (ages 55–79 years)¶
Mammography (every 1–2 years beginning at age 40 years, yearly Hormone therapy beginning at age 50 years)
Sexually transmitted disease testing Skin exposure to ultraviolet rays
Thyroid-stimulating hormone testing Suicide: depressive symptoms
Tuberculosis skin testing Tobacco, alcohol, other drug use
Table 8.3 (Continued )
Immunizations Leading Causes of Death‡‡
Periodic 1. Malignant neoplasms
Diphtheria and reduced tetanus toxoids and acellular pertussis 2. Diseases of the heart vaccine booster (substitute one-time dose of Tdap for Td booster; then boost with Td every 10 years)††
Herpes zoster (single dose in adults aged 60 years or older) 3. Accidents (unintentional injuries)
Inﬂuenza vaccine (annually beginning at age 50 years) 4. Chronic lower respiratory diseases
Varicella vaccine (one series for those without evidence of 5. Cerebrovascular diseases immunity)
High-Risk Groups* 6. Diabetes mellitus
Hepatitis A vaccine (consider combination vaccine for those at 7. Chronic liver disease and cirrhosis risk for hepatitis A and B)
Hepatitis B vaccine (consider combination vaccine for those at 8. Septicemia risk for hepatitis A and B)
Inﬂuenza vaccine 9. Intentional self harm (suicide)
Measles–mumps–rubella vaccine 10. Human immunodeficiency virus (HIV) disease ∗See Table 8.5.
a more detailed discussion of cervical cytology screening, including the use of human papillomavirus DNA testing and screening after hysterectomy, see Cervical cytology screening. ACOG Practice Bulletin No. 109. American College of Obstetricians and Gynecologists. Obstet Gynecol 2009:114: 1409–20.