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If you’ve hit a milestone or are approaching one, it’s time to think about health screens. A little prevention can help ward off the top three health threats for women: heart disease, breast cancer and osteoporosis. Consider these tests through the ages:

30s
In your 30s you don’t have to worry about any special tests, just the routine ones, including a physical and pap smear every one to three years. (But get that pap—before pap tests, cervical cancer was the leading cause of cancer death in women.) You should also consider a blood pressure and cholesterol check; do these every one to five years depending on results from here on out.


40s
Sorry, ladies. With the 40s comes the aging process and with it, a few more tests to consider. Plan on a physical, pap smear and blood pressure check every year. You’ll also want to add an annual stool occult blood test—a simple test you can even do at home—to screen for colon cancer yearly. When you turn 45, guidelines recommend adding a fasting glucose test to screen for diabetes yearly, or every three years from then on if results are normal.

With mammograms, you’ve got a decision to make. You may have heard that the US Preventative Services Task Force recently shocked the health care world by announcing that it no longer recommended women get mammograms yearly at age 40 and went as far as saying women could wait until 50 and then just get one every two years. The reaction from the American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists was one of dismay.

While mammograms can be a hassle and create extra expense and worry with false negatives and unnecessary biopsies of lumps or cysts, they do catch breast cancer 96 percent of the time. The task force’s advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but screening 1,900 women in their 40s to save a life is not. The response from the ACS was that the task force is basically “telling women that mammography at ages 40 to 49 saves lives, just not enough of them,” as stated by the society's chief medical officer, Dr. Otis Brawley. Indeed, women do get breast cancer in their 40s. Another shocker from the task force is that breast self-exams do no good. This one should give you pause—checking breasts in the shower takes mere seconds and there are plenty of women who have found suspicious lumps that carry the telltale signs of being firm and not tender and sticking around through several cycles.

A good rule of thumb might be to have a mammogram every two years in your 40s and continue self checks on a fairly regular basis. Again, this is a decision each woman must make for herself. The good news is that the change in recommendations shouldn’t affect insurance coverage for mammograms.

50s
This new decade brings more regular tests. Add an annual or bi-annual mammogram to your list. You’ll also have to get your first baseline sigmoidoscopy or colonoscopy to check for colon cancer, but if results are good you won’t need another for five to ten years. This is a good test not to blow off, as colorectal cancer rates increase markedly after 50. Chances increase with a history of inflammatory bowel disease (IBD) and polyps. A bonus is that you can wait until your 60s to get a bone density scan for osteoporosis.

Finally, the 50s often bring menopause and with it, a decision on hormone replacement therapy (HRT). Estrogen and progesterone were given widely pre-2000 to ward off menopause symptoms such as hot flashes and mood swings. Yet in 2002, new discoveries of health risks—such as an increased chance of osteoporosis, colorectal cancer and heart disease—put the stops on common use of HRT. While the risk isn’t significant, it is still one to weigh against severity of menopause symptoms.

Now that you know what’s headed your way with each new decade, take charge of your health with a few preventive tests. They don’t take much time or often expense—many can be done at health fairs—so there really is no reason to delay.