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Preventive Screening Guidelines for Healthy Adults

Getting preventive care is one of the most important steps you can take to manage your health. That's because when a condition is diagnosed early, it is usually easier to treat. And regular checkups can help you and your doctor identify lifestyle changes you can make to avoid certain conditions.

Please see the screening guidelines below to see if you're up-to-date.1

Routine Checkups 19–21 years 22–26 years 27–49 years 50–59 years 60–64 years 65+ years
Includes personal history; blood pressure; body mass index (BMI); physical exam; preventive screening; and counseling Annually for ages 19–21
    Annually Annually Annually
Every 1–3 years, depending on risk factors
Cancer Screenings
Colorectal Cancer Not routine except for patients at high risk

Colonoscopy at age 50 and then every 10 years; or annual fecal occult blood test (FOBT) plus sigmoidoscopy every 5 years; or sigmoidoscopy every 5 years

Skin Cancer Periodic total skin exams every 3 years at discretion of clinician Annual total skin exam at discretion of clinician
Breast Cancer (Women) Annual clinical breast exam
  Mammography every two years age 50–74; Mammography before age 50 done under individual context after discussing risks, benefits and harms. After age 75, discuss benefits and limitations
Cervical Cancer (Women) Cytology (pap smear) every 3 years age 21–65, or Cytology with HPV every 5 years for age 30–65
Testicular and Prostate Cancer (Men) Clinical testicular exam at each health maintenance visit Informed decision making regarding PSA Screening starting at age 45-50 depending on risk
Infectious Disease Screening
Body Mass Index (BMI) Regular screening for all adults  
Blood Pressure (Hypertension) At every medical encounter perform blood pressure screening for hypertension—once every two years for blood pressure less than 120/80 mm Hg, and every year for systolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 89 mm Hg  
Sensory Screenings
Eye Exam Up to age 39 years at discretion of clinician Every 1–2 years
Hearing Assessment Unnecessary if asymptomatic
Tetanus, Diphtheria (Td) 1 dose: Tdap; TD booster every 10 years
Influenza 1 dose annually during flu season
Pneumococcal PCV13 1 dose
PPSV23 1-2 doses
Once after age 65, even if previously vaccinated
MMR 1–2 doses if unvaccinated and born after 1957
Meningococcal (Meningitis) 1 or more doses if not previously immunized, depending on risk factors and other indicators
Varicella (Chicken Pox) 2 doses 4–8 weeks apart without evidence of immunity
Shingles Zoster         1 dose
HPV (Human papillomavirus) for Women 3 doses if not previously immunized          
HPV (Human papillomavirus) for Menn 3 doses if not previously immunized For men who have sex with men and immunocompromised men through age 26 if not vaccinated previously        
Hepatitis A 2 doses if not previously immunized if requested or at risk
Hepatitis B 3 doses if not previously immunized
Haemophilus Influenza type B 1 or 3 doses if not previously immunized for patients with asplenia, sickle cell anemia or stem cell transplant and other risk factors


Immunization and Screenings for Healthy Adults.

Please check subscriber certificate/benefit description for a complete listing of covered tests and procedures. Your plan may not cover every screening test listed. These guidelines are generally for healthy children with no current symptoms or prior history of medical condition.

These guidelines were developed by Massachusetts Health Quality Partners (MHQP), a broad-based coalition of health care providers, plans and purchasers working together to promote improvement in the quality of health care services in Massachusetts. Blue Cross Blue Shield of Massachusetts is an MHQP member.