Ages 65 Years and Older: Laboratory and Other Tests

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Ages 65 Years and Older
     Evaluation and counseling


Colorectal cancer screening
□ Aged 76-85 years: screening should be made on an individual basis, taking into account the patient’s overall health and prior screening history.


□ Bone mineral density screening (In the absence of new risk factors, screen no more frequently than every 2 years.) 
□ Cervical cytology: 

  • Age 65: Preferred--Co-test with cytology and HPV testing every 5 years;  Option--Screen with cytology alone every 3 years. 
  • Age 66 years and older: Discontinue in women with evidence of adequate negative prior screening test results and no history of CIN 2 or higher. Adequate negative prior screening test results are defined as three consecutive negative cytology results or two consecutive negative cotest results within the previous 10 years, with the most recent test performed within the past 5 years.

□ Other methods include: 

  1. Fecal occult blood testing or fecal immunochemical test, annual patient-collected (each method requires two or three samples of stool collected by the patient at home and returned for analysis. A single stool sample obtained by digital rectal examination is not adequate for the detection of colorectal cancer.)
  2. Flexible sigmoidoscopy every 5 years
  3. Double contrast barium enema every 5 years
  4. Computed tomography colonography every 5 years
  5. Stool DNA

□ Diabetes testing (every 3 years)
□ Hepatitis C virus testing (one-time testing for persons born from 1945 through 1965 and unaware of their infection status)
□ Lipid profile assessment (every 5 years) 
□ Mammography (Annual or biennial; Begin no later than 50 if patient has not already initiated; Decision to discontinue after 75 should be based on a shared decision-making process that includes a discussion of the woman’s health status and longevity)
□ Urinalysis

*The College supports stopping routine screening at age 75 years.

High-Risk Groups (See High-Risk Table for more information)

□ Hemoglobin level assessment
□ Human immunodeficiency virus (HIV) testing
□ Sexually transmitted infection testing
□ Thyroid-stimulating hormone testing
□ Tuberculosis skin testing

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998