Nearly 50% of Women Skip Preventative Health Appointments—Here Are the Checkups to Prioritize

Nearly half of the women in the United States skipped a preventative healthcare service like an annual well visit, routine vaccination, or recommended test or treatment in the past 12 months, according to a recent survey from Ipsos.

The most common reasons for missing these routine appointments were high costs and the challenges of booking an appointment. Living too far from a primary care provider was another cited reason, as well as a lack of awareness regarding the regularity of certain examinations.

While confusion, annoyance, or a general lack of planning may interfere with the cadence of an individual’s medical appointments, maintaining frequent communication with healthcare professionals is a crucial step in preventative care. It’s often in routine appointments that doctors can detect new signs of illness that may require additional care. Detecting and treating a disease early can stop or slow its progression and substantially improve people’s quality of life.

“The reason that we do these tests is to catch things early,” Amy G. Huebschmann, MD, MSc, FACP, a primary care physician and a researcher with the Ludeman Family Center for Women’s Health Research at the University of Colorado Anschutz Medical Campus, told Health. "There are always things we can do.”

Routine Blood Work

Routine blood work allows doctors to measure lipids, cholesterol levels, blood sugar levels, and complete blood count. These numbers can indicate disorders—like anemia or immune system issues—or chronic conditions such as heart disease, cancer, and diabetes. 

The American Association of Clinical Endocrinology recommends that women at normal risk get screened for lipid disorders every one to two years starting at age 55. Women with diabetes should be screened annually. Women with a family history of elevated cholesterol or heart attack or sudden death should talk to their healthcare provider about screening.

Most women should plan to have their blood sugar levels screened around age 35. But women with a family history of diabetes or a personal history of gestational diabetes should have their blood sugar levels screened earlier than that, advised Dr. Huebschmann. There’s no set schedule for complete blood count tests, as women are mainly advised to schedule blood work if they’re experiencing any abnormal symptoms.

In general, people should plan to have their blood work done every three or so years. However, many individuals will need to do so annually—or potentially every three or six months—if they have abnormal test results or an underlying health condition like high blood pressure or diabetes, said Dr. Huebschmann.

Blood Pressure Screening

Blood pressure is typically taken at the start of every medical appointment. Elevated blood pressure levels can be a marker of heart disease, stroke, and kidney failure, all of which can be treated with medications and lifestyle changes like diet or weight loss, explained Mary Franklin, DNP, CNM, NCMP, FACNM, the director of the Women’s Health Nurse Practitioner Program at Case Western Reserve University. “It’s really important that we catch that early,” she said.

Mental Health Screening

Mental health screenings generally involve a brief questionnaire and can be conducted by primary care physicians, community centers, or clinics. All women 18 and older should be screened for depression at least once a year. The frequency of these screenings will vary based on each individual’s risk factors, comorbid conditions, and life events. 

Evidence suggests 1 in 10 women in the U.S. have experienced symptoms associated with depression, and as many as 1 in 8 women develop depression after giving birth. Mental health screenings are especially important in the postpartum period, Franklin noted.

Pap Tests

Pap tests, more commonly referred to as pap smears, help physicians detect cervical cancer.

“It’s extremely effective,” said Dr. Huebschmann. During a pap smear, cells are scraped from the cervix and sent to a laboratory where the sample is examined. Lab technicians look for two things: traces of the human papillomavirus (HPV) or abnormal changes in the uterine cells that are indicative of cervical cancer, Dr. Huebschmann explained. Caught early, cervical cancer is curable, added Franklin, which is why you want to avoid skipping your routine pap smears.

Regular pap exams kick off at age 21 and are done every three years. At age 30, women can be tested for HPV in addition to the pap smear—if those results are normal, they can wait another five years before their next pap smear. This routine examination continues until age 65. 

Mammograms

Mammograms, or X-ray screenings of the breasts, look for early signs of breast cancer. Up to 1 in 8 women get breast cancer in their lifetime, so “as common as it is, it’s a really important test for women to be doing,” says Dr. Huebschmann.

Most women should start getting mammograms around age 40, repeating the procedure every one to two years. That said, according to Franklin, it’s highly based on risk.

Women who have a high-risk genetic marker—like the BRCA gene, or a first-degree relative with breast cancer—should begin their mammograms younger, potentially in their 20s or 30s. Those at risk may also need to undergo other types of screenings, like MRI scans or ultrasounds, to rule cancer out. You’ll need to tailor your routine mammograms to your medical history, noted Dr. Huebschmann. 

Colon Cancer Screening

Like cervical cancer, colon cancer is curable when it’s detected early. “It’s completely curable if it’s caught early. The later stage it’s caught, the more we have to do to fix it,” explained Franklin. 

Colonoscopies are considered “the gold standard” for detecting colon cancer, however, people without risk factors who want to go a less-invasive route can get a stool test done. Routine colonoscopies begin at age 45; if the results are normal, the test is scheduled every 10 years.

If colon polyps are identified during the colonoscopy, more frequent colonoscopies will be recommended. There are different types of stool tests—some need to be done once a year while others can be completed every three years, according to Dr. Huebschmann.

Bone Density Test

Dr. Huebschmann noted that “Women are much more at risk for osteoporosis than men.”

Women are advised to get their first bone density test at age 65. These tests, which essentially take a scan of the hip and backbones to measure the bones’ thickness, help women gauge their risk of future fractures. Women at risk—those who smoke, weigh less than 126 pounds, have lost at least two inches in height, or have gone through menopause—may qualify for a bone density test earlier, says Franklin.

There is no set schedule for routine bone density tests, however, many people can plan to get re-tested every two to three years. The follow-up schedule will be individualized based on your test results, according to Franklin. 

Sexually-Transmitted Infection (STI) Screening

While there are a number of STIs that women can get tested for, there are three that all women should be screened for: chlamydia, gonorrhea, and HIV. Chlamydia rarely causes symptoms in women, however, it’s strongly associated with infertility, noted Franklin. Gonorrhea, on the other hand, is easier to detect since it triggers noticeable symptoms. Untreated, it can lead to further health issues like pelvic inflammatory disease, liver damage, and arthritis, she added.

Women under the age of 25 should be screened for chlamydia and gonorrhea at least once. Women over 25 who have new or multiple sexual partners should plan to get tested for chlamydia and gonorrhea more frequently, ideally once a year, and if need be, every three to six months. Everyone is advised to get tested for HIV at least once—those at risk should get tested at least once a year.

Lung Cancer Exam

Lung cancer is the leading cause of cancer deaths, largely because it’s rarely caught early. Early-stage lung cancer has a better prognosis, making routine screenings potentially life-saving. Detecting lung cancer early can significantly improve longevity and quality of life, confirmed Franklin.

People between the ages of 50 to 80 who smoke or used to smoke heavily should get their lungs examined for lung cancer. The lungs are screened via a CT scan, which is repeated annually until it’s been 15 years since the patient has smoked.

Teeth Cleaning and Dental Exams

Everyone should aim to get dental cleanings every six months, said Franklin. People who get cavities or gum disease despite having regular cleanings may consider having their teeth cleaned every three months, Dr. Huebschmann noted.

Regular dental cleanings prevent gum disease and cavities and help lower the risk of infections and many other health conditions, like heart attacks. “Good oral health really sets you up for good general health,” Franklin said.

Making a Routine Plan

Once you meet with a physician and go over your medical history, family history, and risk factors, the frequency at which you need to do these routine health exams will change. Many of these conditions are treatable and caught early, can improve, and in some cases, be cured.

Franklin confirmed, “There are so many benefits to sitting down with someone and getting a tailored plan—here’s how we’re going to do screenings and when—just to keep people as healthy as possible.”