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    Preventative Care Guidelines

    It's a question asked often by healthy adults. The Preventive Health Care Guidelines have been prepared by Sutter Health physicians to help you understand the need to schedule preventive medical care.

    Birth - 18 Years  |  19 to 39 Years  |  40 to 49 Years  |  50 to 64 Years  |  65 & Over  |  Definition of Terms  |  Printable Versions

    Birth - 18 Years

    Immunizations/Vaccinations
    The following immunizations should be given between birth and 18 years. As different vaccine schedules are required depending upon the vaccine product and type your group uses, consult your pediatrician or family physician for the best schedule for your child:

    Sutter Pacific's suggested vaccination chart
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    19 to 39 Years

    Women's Health
    Pap Smear: At the onset of sexual activity and every 3 years

    Chlamydia: Every year at the onset of sexual activity through age 25

    Immunizations/Vaccinations
    Tetanus-diphtheria: Booster every 10 years

    Laboratory Testing
    Lipid Screening: Men begin at 35
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    40 to 49 Years

    Women's Health
    Pap Smear: At least every three years
    Mammogram*: Every 1-2 years starting at 40

    Laboratory Testing
    Cholesterol: Every 5 years, women begin at 45

    Immunizations/Vaccinations
    Tetanus-diphtheria: Booster every 10 years
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    50 to 64 Years

    Sigmoidoscopy1: At least every 10 years; *optional every five years
    and
    Fecal Occult Blood1: Annually

    Women's Health
    Pap Smear: At least every three years.
    Mammogram: Every 1-2 years

    Laboratory Testing
    Lipid Screen: Every five years
    PSA (for men): *Optional annually

    Immunizations/Vaccinations
    Tetanus-diphtheria: Booster every 10 years

    1Fecal Occult Blood screening should be combined with sigmoidoscopy. Colonoscopy every 10 years is an acceptable alternative to the conbined FOBT and sigmoidoscopy screening.
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    65 & Over

    Sigmoidoscopy1: At least every 10 years until age 70; optional every five years

    Fecal Occult Blood: Annually until 80

    Women's Health
    Pap Smear: At least every 5 years until age 65
    Mammogram: Every 1-2 years until age 75
    Bone Density: Optional annually until 70

    Laboratory Testing
    Lipid Screen: Every 5 years until age 65*
    PSA (for men): Optional annually until 70

    Immunizations/Vaccinations
    Tetanus-diphtheria: Booster every 10 years
    Influenza: Optional annually until age 65, then annually
    Pneumococcal: At age 65

    *Screening is discretionary after age indicated. Discuss risks & benefits of screening with your primary care provider.
    1: Studies to confirm benefit have not been conducted
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    Definition of Terms

    Pap Smear: A test for abnormal cervical cells which can indicate increased risk of cervical cancer. This is not a test for uterine or ovarian cancer. Pap smears are done during an internal pelvic exam. Read more about Pap Smears.

    Chlamydia Screening Test: A screening test for detecting chlamydia, a curable sexually transmitted infection that can cause scarring, infertility and chronic pelvic infection. Read more about Chlamydia Testing.

    Fecal Occult Blood: A screening test for hidden blood in the stool, which may be a sign of colon cancer. Read more about the Fecal Occult Blood Test.

    Sigmoidoscopy: An internal inspection of the lower colon to screen for cancer and polyps (pre-cancerous growths). Read more about Sigmoidoscopy.

    Colonoscopy: An internal inspection of the entire colon to screen for cancer and polyps (pre-cancerous growths). Read more about Colonscopy.

    Lipid Screen: A blood test for detecting levels of fats and cholesterol that can increase the risk of heart disease and stroke. Read more about a Lipid Screen.

    PSA: (Prostrate Specific Antigen) A blood test for measuring a protein. High levels may be associated with prostate cancer. Read more about PSA.

    Mammogram: A low dose breast x-ray to screen for breast cancer. Read more about Mammography.

    Bone Density Test: A low dose x-ray to screen for the thinning and weakening of bones, which increase the risk of osteoporosis and fracture. Read more about Bone Density testing.


    References

    References and supporting literature:

    • American Academy of Family Physicians. Clinician's Handbook of Preventive Services. U.S. Public Health Services; 1994.

      • Case-Control Study of Screening Sigmoidoscopy and Mortality from Colorectal Cancer. Selby, J. NEJM 1992; 326:653-7.
    • Efficacy of Screening Mammography. Kerlikowski, K. JAMA. 1995; 273:149-154.

    • Screening for Colorectal Cancer. Toribara, N. NEJM 1995; 332:861-867.

    • Screening for Cervical Cancer. Eddy, D. Annals of Internal Medicine 1990; 113:214-226.

    • Screening for Prostate Cancer. Krahn, M. JAMA. 1994; 272:773-780. U.S Preventive Services Task Force. Guide to Clinical Preventive Services. Baltimore, Md: Williams & Wilkins, 1996.

    • Health Promotion and Disease Prevention in Clinical Practice. Baltimore, Md: Williams & Wilkins, 1996.
    • Colorectal Cancer Screening Clinical Guidelines.
      • Rational Winawer, S. et al. Gastroenterology 1997;112:594-642.

    Recommended reading:

    • Healthwise Handbook. Donald W. Kemper, Healthwise, Inc.
      Caring for Your Baby and Young Child. The American Academy of Pediatrics.

    • Take Care of Yourself. By Vickery & Fries.

    • Taking Care of Your Child. By Pantell, Vickery & Fries.

    • Living Well. Taking Care of Your Health in the Middle and Later Years. By Fries.

    • Cuidate: Guia para una mejor atencion medica. By Vickery & Fries.
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      Printable Versions


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