QUEST Integration – Primary Preventive Services – Women

The following recommendations for women are based on the Report of the U.S. Preventive Services Task Force, Second Edition, the American Diabetes Association and the Hawaii State Department of Health. Their appropriate use should be a shared decision between physician and patient.

Screening Age Recommended Frequency
Blood pressure

18-65 years

Older than 65

At each office visit or every two years for normotensive adults

Annually

Cholesterol 45-65 years Every five years

FOBT and/or

Sigmoidoscopy

45 years or older

Annually

Every five years

Pap smear 18-65 years One per calendar year
Chlamydia 25 years or younger All sexually active women and other asymptomatic women at increased risk for infection
Random or fasting plasma glucose test 45 years or older Every three years; younger or more frequently if at high risk
Eye exam   Clinical discretion
Dental exam; See notes below (1) Ongoing Regular visits to dental provider; brush and floss daily
Hearing exam   Clinical discretion
Depression Adult Adults should be screened for depression when accurate diagnosis, effective treatment, and careful follow-up can be ensured
Osteoporosis

High risk: 60 years or older

Normal risk: 65 years or older

See notes below (2)
  1. Dental exams, though a recommended screening, are not a QUEST Integration benefit for adults.
  2. No studies have evaluated the optimal intervals for repeated screening. Because of limitations in the precision of testing, a minimum of two years may be needed to reliably measure a change in bone mineral density; however, longer intervals may be adequate for repeated screening to identify new cases of osteoporosis. Yield of repeated screening will be higher in older women, those with lower BMD at baseline and those with other risk factors for fracture.

There are no data to determine the appropriate age to stop screening and few data on osteoporosis treatment in women older than 85. Patients who receive a diagnosis osteoporosis fall outside the context of screening but may require additional testing for diagnostic purposes or to monitor response to treatment.

Health Education Age Recommended Frequency
Tobacco, alcohol, drugs Ongoing Associated risks
Diet, exercise Ongoing Associated benefits
Adequate calcium Ongoing  
Lap/shoulder car belt Ongoing  
Safety, injury prevention Ongoing  
High-risk sexual behavior Ongoing  
Unintended pregnancy Ongoing  
Immunization Schedule Age Recommended Frequency
Influenza vaccine 50 years or older Annually; younger if at increased risk

Td (tetanus, diphtheria)

booster

  Every ten years for adults; if five-dose series completed in childhood every 15-30 years may be adequate
Pneumococcal vaccine 65 years or older Younger if at increased risk; use clinical discretion to consider revaccination for individuals vaccinated prior to age 65 if five or more years have elapsed
Rubella   Prior to childbearing age if no documented history of immunization or disease

Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.