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    Preventative Care Guidelines

    Partnering for Your Best Health

    We’re here to partner with you in your complete health and wellness. At Sutter Health, you have a complete care team with you. We believe in partnering in your health wellness so you can feel your best.

    Find out when check ups, screenings and immunizations are generally recommended, then talk with your provider or care team about what’s right for you.

    Birth - 18 Years  |  19 to 39 Years  |  40 to 49 Years  |  50 to 74 Years  |  75 & Over  |  Definition of Terms


    Birth - 18 Years

    Check Ups

    Visits at 1, 2, 4, 6, 9, 12, 15 and 18 months of age. Annual visits from ages 2 to 6. Visits every other year for ages 6 to 17.

    Screening Tests

    Vision: Check once before age 5.
    Obesity: Monitor starting at age 6.
    Chlamydia/Gonorrhea: Check yearly for sexually active females ages 15 to 24 years.
    HIV/AIDS: Check between ages 15 and 65.

    Immunizations

    Two month series of vaccines can be given as early as 6 weeks.

    Immunizations

    Recommendations

    Hepatitis B

    Birth, 1 month, 6 months

    Haemophilus Influenza Type B

    2 month, 4 months, 6 months, 12 months

    Polio

    2 months, 4 months, 6 months, 4-5 years

    Diphtheria, Tetanus and Acellular Pertussis

    2 months, 4 months, 6 months, 18 months, 4-5 years
    Rotavirus2 months, 4 months, 6 months
    Pneumococcal2 months, 4 months, 6 months, 12 months
    Tdap/Td:11 years
    Measles, Mumps and Rubella 12 months, 4-5 years
    Varicella (Chickenpox)12 months, 4-5 years
    Hepatitis A12 months, 18 months
    Influenza (yearly) 6 months, 18 months, 2 years, 4-5 years, 11 years, 16 years
    Conjugated Meningococcal11years, 16 years
    Human Papillomavirus
    Females ages 9–26 and males 11–21 should receive the HPV series 0, 2 and 6 month intervals.
    11 years


    Human Papillomavirus (HPV): Females and males ages 11 to 14 years should receive a two-dose series, and females ages 15 to 26 and males ages 15 to 21 should receive a three-dose series.
    Pregnancy: If you are pregnant or able to get pregnant, take a daily vitamin or supplement containing 0.4 to 0.8 mg of folic acid. Talk to your doctor about more steps for a healthy pregnancy.
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    19 to 39 Years

    Wellness Check

    Check blood pressure, screen for healthy weight and assess overall health.

    Screening Tests

    HIV/AIDS: Check between ages 15 and 65.

    Immunizations

    Influenza (Flu): Yearly flu vaccine.
    Varicella (Chickenpox): A vaccine for adults born in 1980 or later.
    HPV (Human Papillomavirus): Unvaccinated females ages 15 to 26 and males ages 15 to 21 should receive a three-dose series.
    MMR (Measles, Mumps and Rubella): Adults ages 19 to 59 should have recorded in their chart at least one dose of the vaccine.
    Tdap/Td (Tetanus, Diphtheria and Pertussis/Tetanus and Diphtheria): Adults younger than age 65 should receive a tetanus vaccine (Tdap or Td) every 10 years.

    Men’s Health

    Cholesterol: Check every five years starting at age 35.

    Women’s Health

    Chlamydia/Gonorrhea: Check yearly for sexually active females ages 15 to 24 years.
    Cervical Cancer: Pap test every three years for all women ages 21 to 29. Pap test with HPV screening every five years for all women ages 30 to 65.
    Pregnancy: If you are pregnant or able to get pregnant, take a daily vitamin or supplement containing 0.4 to 0.8 mg of folic acid. Talk to your doctor about more steps for a healthy pregnancy.
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    40 to 49 Years

    Wellness Check

    Check blood pressure, screen for healthy weight and assess overall health.

    Screening Tests

    HIV/AIDS: Check between ages 15 and 65.

    Immunizations

    Influenza (Flu): Yearly flu vaccine.
    MMR (Measles, Mumps and Rubella): Adults ages 19 to 59 should have recorded in their chart at least one dose of the vaccine.
    Tdap/Td (Tetanus, Diphtheria and Pertussis/Tetanus and Diphtheria): Adults younger than age 65 should receive a tetanus vaccine (Tdap or Td) every 10 years.

    Men’s Health

    Cholesterol: Check every five years starting at age 35.

    Women’s Health

    Cervical Cancer: Pap test with HPV screening every five years for all women ages 30 to 65.
    Pregnancy: All females who are pregnant or able to get pregnant should take a daily vitamin or supplement containing 0.4 to 0.8 mg of folic acid. Talk to your doctor about additional steps for a healthy pregnancy.
    Breast Cancer Screening: Mammography is optional every other year. Talk to your doctor about your options for breast cancer screening. It’s your decision whether to start screening before the age of 50.
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    50 to 74 Years

    Wellness Check

    Check blood pressure, screen for healthy weight and assess overall health.

    Screening Tests

    HIV/AIDS: Check between ages 15 and 65.
    Hepatitis C: Check adults born between 1945 and 1965.
    Colon Cancer: Preferred Screening Options — A colonoscopy every 10 years, a stool FIT* test every year or a sigmoidoscopy every 10 years with annual FIT testing. Other Options— A CT colonography every five years or a FIT/DNA test every three years.
    *FIT= Fecal Immunochemical Test

    Immunizations

    Influenza (Flu): Yearly flu vaccine.
    MMR (Measles, Mumps and Rubella): Adults ages 19 to 59 should have recorded in their chart at least one dose of the vaccine.
    Tdap/Td (Tetanus, Diphtheria and Pertussis/Tetanus and Diphtheria): Adults younger than age 65 should receive a tetanus vaccine (Tdap or Td) every 10 years.
    Zoster (Shingles): Vaccine for adults at age 60.
    Pneumococcal (Pneumonia): At least two vaccinations (injections) one year apart beginning at age 65.

    Men’s Health

    Cholesterol: Check every five years.
    Prostate Cancer: Talk to your doctor about your risk. Regular screening is not recommended for men who have an average risk.

    Women’s Health

    Cervical Cancer: Pap test with HPV screening every five years for all women ages 30 to 65.
    Breast Cancer: Mammography every two years.
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    75 & Over

    Wellness Check

    Check blood pressure, screen for healthy weight and assess overall health.

    Screening Tests

    Colon Cancer: The decision to screen for colorectal cancer in adults ages 76 to 85 years should be an individual one, taking into account the patient’s overall health and prior screening history.

    Immunizations

    Tdap/Td (Tetanus, Diphtheria and Pertussis/Tetanus and Diphtheria): Adults age 65 and older may receive a tetanus vaccine (Tdap or Td) every 10 years.

    Men’s Health

    Prostate Cancer: Talk to your doctor about your risk. Regular screening is not recommended for men who have an average risk.

    Women’s Health

    Breast Cancer: Mammography is optional after age 74.

    These guidelines may vary for patients with personal or family health risks or who take certain medications.
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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 Colonoscopy.

    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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