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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 18-29 years 30-39 years 40-49 years 50-64 years 65+ years
Includes personal history; blood pressure; body mass index (BMI); physical exam; preventive screening; and counseling Annually for
ages 18–21
    Annually Annually
Every 1–3 years, depending on risk factors2
Cancer Screenings          
Colorectal Cancer Not routine except for patients at high risk2

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, or double-contrast barium enema 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 and monthly self-exam
  Annual mammography
at discretion
of clinician
Annual mammography
at discretion
of clinician
Cervical Cancer (Women) Initiate Pap test at 3 years after first sexual intercourse, or by age 21 every 1-3 years,3 depending on risk factors2
Testicular and Prostate Cancer (Men) Clinical testicular exam at each health maintenance
visit and monthly self-exam
Annual Digital Rectal Exam (DRE)
or prostate-specific antigen (PSA)
blood test at discretion of clinician
    Digital Rectal
Exam (DRE) or
antigen (PSA) blood
test if at high risk2
Other Recommended Screenings          
Body Mass Index (BMI) At discretion of clinician (can be screened annually for overweight and eating disorders, consult the CDC's growth and BMI charts)
Blood Pressure (Hypertension) At every acute/nonacute medical encounter and at least once every 2 years
Cholesterol Every 5 years or more often at discretion of clinician
Diabetes (Type 2)     Every 3 years, beginning at age 45 or more often and beginning
at a younger age at discretion of clinician
Bone Mass Density (BMD) Test (Women)     Consider your risk factors, discuss with you
clinician. BMD testing for all post-menopausal
women who have one or more risk factors for
osteoporosis fractures.
BMD test once,
or more often at
discretion of clinician
Infectious Disease Screening          
Sexually Transmitted Infections
(Chlamydia, Gonorrhea, Syphilis, and HPV)
Annual screenings for sexually active patients under 25; annually for patients age 25 and over if at risk2
HPV is for age 26 and under, if not previously vaccinated.
Sensory Screenings          
Eye Exam for Glaucoma At least once. Every 3–5 years if at risk2 Every 2–4 years Every 1–2 years
Hearing and Vision Assessment At discretion of clinician
Tetanus, Diphtheria (Td) 3 doses if not previously immunized. Booster every 10 years
Influenza Every year if at high risk2 Annually
Pneumococcal If at high risk2 and not previously immunized Once after age 65,
even if previously
Meningococcal (Meningitis) 1 or more doses if not previously immunized, depending on risk factors and other indicators2
Varicella (Chicken Pox) 2 doses given at or after age 13 if susceptible2


Immunization and Screenings for Healthy Adults.

1. Please check subscriber certificate/benefit description for a complete listing of covered tests and procedures. Your plan may not cover every screening test listed.

2. Contact your physician to determine if you are at risk.

3. Pap test may be performed at three-year intervals only after three consecutive negative results.

The following screening tests and vaccinations are not routinely recommended, but may be appropriate depending on your age and/or risk: HIV test (HIV/AIDS); Hepatitis A, B, and C tests; Glucose (Type II Diabetes) test; Tuberculosis skin test; and Measles, Mumps, Rubella, and Hepatitis A and B vaccines.

The Preventive Screening Guidelines for Healthy Adults are general guidelines for healthy adults with no current symptoms or personal history of medical conditions. People with medical conditions, or those with a family history for certain diseases, should talk with their doctor about the right recommendations for them.

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.