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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. As always, consult with your doctor for the screenings and immunizations most appropriate for you.

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

Well Visit 18–21 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 Every 1–3 years, depending on risk factors Annually
Cancer Screenings
Colorectal Cancer Not routine, except for patients at high risk
  • Colonoscopy at age 50 and then every 10 years, or
  • Annual fecal immunochemical test (FIT), or
  • Sigmoidoscopy every 5 years plus fecal occult blood test (FOBT) every 3 years, or
  • Annual FOBT
Skin Cancer Annual total skin exam at discretion of doctor
Breast Cancer (Women) Mammograms before age 50 are performed due to individual context after discussing risks, benefits, and harms with a doctor
  • Mammograms every two years from age 50–74 
  • After age 75, discuss benefits and limitations with your doctor
Cervical Cancer (Women) Cytology (Pap Smear) every 3 years age 21–65, or cytology with HPV every 5 years for age 30–65 if both initial tests are negative
Testicular and Prostate Cancer (Men) Informed decision making regarding prostate-specific antigen screening, or PSA screening, starting at age 40–50 depending on risk
Infectious Disease Screening
Zika Virus At each prenatal visit, health care providers should screen pregnant woman for possible exposure to Zika virus before and during the current pregnancy and possible symptoms of Zika virus infection.  
Chlamydia and Gonorrhea
  • Annual chlamydia screening for all sexually active women younger than 25 years and sexually active women 25 years or older with risk factors (e.g., a history of prior chlamydial or other sexually transmitted infection, new or multiple sex partners, sex partner with concurrent partners, sex partner with a sexually transmitted infection, or exchanging sex for drugs or money)
  • Routine gonorrhea screening should be offered to sexually-active patients at high risk of infection
HIV Routine screenings for patients 18 years and older, and annual for those at increased risk
Syphilis Screenings for all pregnant women, and those at increased risk
Sensory Screenings
Eye Exam
  • Every 2-4 years, age 40–54
  • Every 1-3 years, age 55–64
Every 1-2 years
Hearing Assessment Unnecessary if asymptomatic
Tetanus, Diphtheria (Td) 1 dose of Td, then Td booster every 10 years
Influenza 1 dose annually
Pneumococcal PCV13 1 dose given first
PVSV23 1, 2 or 3 doses if indicated
Once, even if previously vaccinated
Measles, Mumps, & Rubella (MMR) 1–2 doses recommended for adults who meet the age requirement, lack documentation of vaccination, or lack evidence of past infection
Meningococcal (Meningitis) 1 or more doses if not previously immunized, depending on risk factors and other indicators; 10 or more doses depending on immunity or past vaccinations
Varicella (Chicken Pox) 2 doses 4–8 weeks apart without evidence of immunity
Herpes Zoster (Shingle)   1 dose
HPV (Human papillomavirus) 3 doses if not previously immunized  
Hepatitis A 2 or 3 doses if not previously immunized when requested, or at risk
Hepatitis B 3 doses if not previously immunized
Haemophilus Influenza type B
  • 1 dose for patients with asplenia, or sickle cell anemia
  • 3 doses for patients with Hematopoietic Stem Cell Transplant History (HSCT)
Other Recommended Screenings
Body Mass Index (BMI) Regular screening for all adults  
Blood Pressure (Hypertension) Check at every visit and 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
  • Screen for lipid disorder (high cholesterol) starting at age 18
  • Regular screenings for men over 35, and women over 45 who are at risk for heart disease
  • Regular screenings for men 18–35, and women 18–45 who have an increased risk for heart disease


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 adults with no current symptoms or prior history of medical condition.

1 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.


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