Important Health Screenings
DEAR MAYO CLINIC: I'm a 35-year-old woman in generally good health. I've never been pregnant and have no plans to be pregnant in the near future. At this age, do I need to start having annual checkups? If so, what should they include?

ANSWER: At 35 and with good health, regular visits might not mean annual visits. However, you still need to see your care provider regularly for important health screenings and for counseling that could reduce the risk of illness. You and your provider can decide how often these visits should occur.

Your periodic exam is an opportunity to identify behavioral health risks and create strategies to minimize them over time. Research continues to highlight behaviors that make a significant difference in longevity. They are:

--Adequate physical activity

--Diet that emphasizes fruits and vegetables

--Abstinence from tobacco and avoidance of tobacco smoke

--Avoidance of hazardous and harmful drinking

People who have established healthy behaviors in these areas before age 50 have mortality rates that are 40 percent lower than those who make less healthy choices. Healthy choices can translate into a longer life -- a decade or more longer. A care provider can offer counseling to help you stay on track or make needed changes.

In addition to reviewing your health behaviors and health risks, your provider will review available screening options for preventable conditions and will recommend what screening tests and procedures you need and how often you need them. Following are other areas typically reviewed or performed in a periodic exam:

Pap smear: This highly effective screening for cervical cancer is recommended at least every three years after age 21 or when a woman first becomes sexually active. For women with new sexual partners, the screening is recommended annually.

Sexually transmitted diseases: Doctors routinely screen for sexually transmitted diseases in women age 25 and younger. But, if you're sexually active and either you or your partner has had multiple partners, screening for sexually transmitted diseases is recommended. Chlamydia, for example, often has no symptoms but can cause fertility problems.

Mammography: Most women begin this breast cancer screening at age 40. Your provider might suggest you start now if you are at high risk because of a family history or a known genetic mutation in the BRCA gene.

Blood pressure: This should be checked every two years. Ideally, your blood pressure should be lower than 120/80 mm Hg. If it's higher, or if you take birth control pills, blood pressure should be monitored every year.

Osteoporosis: Women typically reach their peak bone mass at your age. Your provider can review your risk of osteoporosis in the future and advise steps you can take now to reduce the likelihood of developing this condition.

Immunization review: Shots aren't just for kids. You may need some, depending on your health history and previous immunizations. Options include a measles/mumps/rubella booster or vaccinations for influenza, tetanus or meningitis. Hepatitis immunizations may be necessary if you are planning to travel internationally, or your job exposes you to blood or body fluids.

Cholesterol: Recommendations vary on when to start cholesterol screening. Your provider might recommend this blood test now, especially if you have a family history of high cholesterol, heart disease or other risk factors. If screening results are normal, cholesterol checks are recommended every five years.

Diabetes: Your provider might order a blood test to check for this condition, especially if you're overweight or have a family history of diabetes. Other risk factors are high blood pressure and high cholesterol levels.

Tobacco use: If you use tobacco, your provider can offer tools to help you quit. Nicotine replacement and other medications can help reduce cravings.

Colon cancer: This screening isn't recommended until age 50 unless you have a family history of the illness or have inflammatory bowel disease. In those situations, screening is recommended starting at age 40.

In addition to completing the above tests and reviewing your health risks, having a periodic evaluation allows you to establish a primary care home. This connection to a primary care team means that if you do become ill, they will be prepared to step in and care for you quickly and seamlessly.

Schedule a checkup and talk with your provider about your current health, any risks you might have, and what you can do about them. You deserve the rewards that preventive care can provide. The health and lifestyle choices you make now will make a difference in your long-term health.