Physical exam frequency
Definition
All adults should visit their
health care provider from time to time, even if they are healthy.
The purpose of these visits is to:
- Screen for diseases
- Assess risk of future medical
problems
- Encourage a healthy
lifestyle
- Update vaccinations
- Maintain a relationship with a
doctor in case of an illness
Alternative Names
How often you need a physical
exam; Health maintenance visit
Information
Even if you feel fine, it is
still important to see your health care provider regularly to check
for potential problems. Most people who have high blood pressure don't even know it. The
only way to find out is to have your blood pressure checked
regularly. Likewise, high blood sugar and high cholesterol levels often do not produce
any symptoms until the disease becomes advanced.
There are specific times when you
should see your health care provider. Age-specific guidelines are
as follows:
AGE
18-39
- Blood pressure screening:
- Have your blood pressure checked
every 2 years unless it is 120-139/80-89 Hg or higher. Then have it
checked every year.
- Watch for blood pressure
screenings in your area. Ask your health care provider if you can
stop in to have your blood pressure checked. Check your blood
pressure using the automated machines at local grocery stores and
pharmacies.
- If the top number (systolic
number) is greater than 130 or the bottom number (diastolic number)
is greater than 85, call your doctor.
- If you have diabetes, heart
disease, kidney problems, or certain other conditions, you may need
to be monitored more closely.
- Cholesterol screening:
- Men over age 34 should be
checked every 5 years.
- If you have diabetes, heart
disease, kidney problems, or certain other conditions, you may need
to be monitored more closely.
- Dental exam:
- Go to the dentist every year for
an exam and cleaning.
- Eye exam:
- Immunizations:
- After age 19, you should have a
tetanus-diphtheria and acellular pertussis (TdAP) vaccine as one of
your tetanus-diphtheria vaccines one time. You should have a
tetanus-diphtheria booster every 10 years.
- Your doctor may recommend other
immunizations if you are at high risk for certain conditions such
as pneumonia.
- Men: Testicular exam:
- Men should do a monthly
testicular self-exam.
- If you are not sure what you
should be looking for, contact your health care provider for
instruction.
- Physical exam:
- You should have two physical
exams in your 20s.
- During the first exam, ask to
have your cholesterol checked. Other
blood tests are not necessary for healthy young people.
- Your height and weight should be
checked at every exam.
- Women: Breast self-exam:
- Women may do a monthly breast
self-exam.
- Women should contact their
health care provider immediately if they notice a change in their
breasts, whether or not they do breast self-exams.
- A complete breast exam should be
done by a health care provider every 3 years for women age
20-40.
- Women: Pelvic exam and Pap
smear:
- Women should have a pelvic exam
and Pap smear every 1-2 years to
check for cervical cancer, depending on the technique.
- Screening should start within 3
years after first having vaginal intercourse or by age
21.
- If you are over age 30 or your
Pap smears have been negative for 3 years in a row, your doctor may
tell you that you only need a Pap smear every 2-3
years.
- Women who have had a total
hysterectomy (uterus and cervix removed) may choose not to have Pap
smears.
- Women who are sexually active
should be screened for chlamydia infection. This can be done during
a pelvic exam.
AGE
40-65
- Blood pressure screening:
- Have your blood pressure checked
every 2 years unless it is 120-139/80-89 Hg or higher. Then have it
checked every year.
- Watch for blood pressure
screenings in your area. Ask your health care provider if you can
stop in to have your blood pressure checked. Check your blood
pressure using the automated machines at local grocery stores and
pharmacies.
- If the top number (systolic
number) is greater than 130 or the bottom number (diastolic number)
is greater than 85, call your doctor.
- If you have diabetes, heart
disease, kidney problems, or certain other conditions, you may need
to be monitored more closely.
- Cholesterol screening:
- Men over age 34 should be
checked every 5 years.
- Women over age 44 should be
checked every 5 years.
- If you have diabetes, heart
disease, kidney problems, or certain other conditions, you may need
to be monitored more closely.
- Colon cancer screening: People
between the ages of 50 and 80 should be screened for colorectal
cancer. African-Americans need to start screening at age 45. This
may involve:
- A stool test done every year.
- Flexible sigmoidoscopy every 5 years along with a
stool guaiac test.
- Colonoscopy every 10
years.
- Double-contrast barium
enema.
- Computed tomographic
colonography (virtual colonoscopy).
- People with risk factors for
colon cancer such as long-standing ulcerative colitis, personal or
family history of colorectal cancer, or history of large colorectal
adenomas may need a colonoscopy more often.
- Dental exam:
- Go to the dentist every year for
an exam and cleaning.
- Eye exam:
- If you have vision problems,
continue to have an eye exam every 2 years.
- Everyone (with or without eye
problems) should begin to have regular eye exams every 2 years
after age 40.
- Once you turn 45, make sure that
you have tonometry done to check for
glaucoma.
- Immunizations:
- You should receive a flu vaccine
every year after age 50.
- Ask your doctor if you should
get a vaccine to reduce your risk of pneumonia.
- You should have a
tetanus-diphtheria booster vaccination every 10 years.
- A shingles or herpes zoster
vaccination may be given once after age 60.
- Physical exam:
- Have a physical exam every 1-5
years.
- Your height, weight, and body
mass index (BMI) should be checked at each exam.
- Routine diagnostic tests are not
recommended.
- Men: Prostate exam:
- Most men age 50 or older should
discuss screening for prostate
cancer with their health care provider. African-American men
and those with a family history of prostate cancer should start at
age 45.
- Screening tests may include the
PSA blood test and a digital rectal examination.
- Women: Breast exams:
- Women may do a monthly breast
self-exam.
- Women should contact their
doctor immediately if they notice a change in their breasts,
whether or not they do self exams.
- A complete breast exam should be
done by a health care provider every year.
- Women: Mammograms:
- Women over the age of 40 should
have a mammogram done every 1-2
years depending on risk factors to check for breast cancer.
- Women: Osteoporosis
screening:
- All postmenopausal women with
fractures should have a bone density
test (DEXA scan).
- Women under 65 who have risk
factors for osteoporosis should be
screened.
- Men: Osteoporosis
screening:
- All men ages 50-70 with risk
factors for osteoporosis should discuss screening with their
doctor.
- Women: Pelvic exam and Pap
smear:
- Women should have a yearly
pelvic exam and Pap smear done to check for cervical cancer and
other disorders.
- If your Pap smears have been
normal for 3 years in a row, your doctor may tell you that you only
need a Pap smear to every 2-3 years.
- Women who have had a total
hysterectomy (uterus and cervix removed) may choose not to have Pap
smears.
- Women who are sexually active
should be screened for chlamydia infection. This can be done during
a pelvic exam.
AGE 65 AND
OLDER
- Abdominal aortic aneurysm
screening:
- Men between ages 65 - 75 who
have smoked should have an ultrasound done once to screen for
abdominal aortic
aneurysms.
- Others should discuss such
screening with their health care provider.
- Blood pressure screening:
- Have your blood pressure checked
every year.
- If you have diabetes, heart
disease, kidney problems, or certain other conditions, you may need
to be watched more closely.
- Cholesterol screening:
- If your cholesterol level is
normal, have it rechecked every 3-5 years.
- If you have diabetes, heart
disease, kidney problems, or certain other conditions, you may need
to be monitored more closely.
- Colon cancer screening: One of
the following screening tests should be done:
- A stool test every
year
- Flexible sigmoidoscopy every 5
years along with a stool guaiac test
- Colonoscopy every 10
years
- Computed tomographic
colonography (virtual colonoscopy)
Note: Patients with risk factors
for colon cancer, including long-standing ulcerative colitis,
personal or family history of colorectal cancer, or history of
large colorectal adenomas may need a colonoscopy more
often.
- Dental exam:
- Go to the dentist every
year.
- Eye exam:
- Have an eye exam every 2
years.
- Make sure your health care
provider checks for glaucoma.
- Hearing test:
- Have your hearing tested every
year.
- Immunizations:
- If you are over 65, get a
pneumococcal vaccine if you have never had before, or if you
received one more than 5 years before your turned 65.
- Get a flu shot every year.
- Get a tetanus -diphtheria
booster every 10 years.
- A shingles or herpes zoster
vaccination may be given once after age 60.
- Men: Prostate exam:
- All men should discuss prostate
cancer screening with their health care provider.
- Screening may involves a PSA
test or digital rectal exam.
- Physical exam:
- Have a yearly physical
exam.
- With each exam, you should have
your height and weight checked.
- Routine diagnostic tests are not
recommended unless your doctor finds a problem.
- Women: Breast exams:
- Women may do a monthly breast
self-exam.
- Women should contact their
doctor immediately if they notice a change in their breasts,
whether or not they do self exams.
- A complete breast exam should be
done by a health care provider every year.
- Women: Mammograms:
- Women should have a mammogram
done every 1-2 years depending on risk factors to check for breast
cancer.
- Women: Osteoporosis
screening:
- All women should have a bone density test (DEXA scan).
- Ask your doctor about the proper
calcium intake and exercise needed to help prevent
osteoporosis.
- Men: Osteoporosis
screening:
- All men over age 70 should have
a bone density test (DEXA scan).
- Women: Pelvic exam and Pap
smear:
- Women should have a yearly
pelvic exam and Pap smear done to check for cervical cancer and
other disorders.
- If your Pap smears have been
negative for 3 years in a row, your doctor may tell you that you
only need a Pap smear to every 2 - 3 years.
- Women who have had a total
hysterectomy (uterus or cervix removed) may choose not to have Pap
smears.
- If you are over 70 and your Pap
smear has been normal for 10 years, or if your test results have
been normal for 3 years in a row, you may choose not to have any
more Pap smears.
References
U.S. Preventive Services Task
Force. Screening for Abdominal Aortic Aneurysm. Rockville,
MD: Agency for Healthcare Research and Quality; February
2005.
U.S. Preventive Services Task
Force. Screening for Chlamydial Infection. Rockville, MD:
Agency for Healthcare Research and Quality; June 2007.
Smith RA, Cokkinides V, Brawley
OW. Cancer Screening in the United States, 2008: a review of
current American Cancer Society guidelines and cancer screening
issues. CA Cancer J Clin. 2008;58(3):161-79. Epub 2008 Apr
28.
Gaziano JM, Manson JE, Ridker PM.
Primary and secondary prevention of coronary heart disease. In:
Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart
Disease: A Textbook of Cardiovascular Medicine. 8th ed.
Philadelphia, PA; Saunders Elsevier; 2007: chap 45.
American Diabetes Assocation.
Standards of medical care in diabetes -- 2008. Diabetes
Care. 2008;31(suppl 1):S12-54.
National Osteoporosis Foundation.
Clinician's
Guide to Prevention and Treatment of Osteoporosis. Feb. 2008.
Accessed Feb. 22, 2008.
Review Date: 5/2/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX
Northwest Division of Physician Assistant Studies, University of
Washington, School of Medicine. Also reviewed by David Zieve, MD,
MHA, Medical Director, A.D.A.M., Inc.
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