Medical screenings after 65

Recommendations for medical screenings change once we’re in our senior years. Some procedures are added, some go away. Most women can skip cervical cancer screening after 65, and most men prostate cancer screening after 70. People over 75 with negative previous screenings for colon cancer can stop having colonoscopies. 

On the addition side is a DEXA scan to detect bone loss, which can lead to debilitating fractures. A number of medical organizations recommend a first DEXA scan for women at 65 and men at 70.

Also recommended for older people are the one-time pneumonia vaccine and the Shingrix vaccine to guard against shingles, a painful rash.

A few of the recommendations (rather, nonrecommendations) of the US Preventive Services Task Force, a volunteer panel of medical experts that sets screening guidelines, bewilder me. There are no recommendations about seniors’ testing for hearing or vision loss or skin cancer, and the recommended age for mammograms ends at 74.

An American woman who reaches 75 can expect to live 17 more years, yet the USPSTF “concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.” The American Cancer Society differs; it recommends that mammograms continue for women with good health and a life expectancy of at least 10 more years. I’ll be curious to learn what my doctor recommends when I reach 75.

The USPSTF uses the same “benefits and harms” language about hearing screening. Wondering what harms could come from a hearing test, I did a quick Google search and didn’t find any. An estimated one-third of adults between 65 and 74, and nearly half of those over 75, have age-related hearing loss, and not even one-quarter of them wear hearing aids. The hard of hearing who go untreated may lose cognitive ability along with quality of life.  

Maybe the USPSTF’s viewpoint is the reason that my primary care physician doesn’t mention hearing, vision, and skin cancer screenings. 

A free hearing test at a health fair alerted me to my hearing decline. 

Because growths and spots appear with increasing frequency as we age, I sought the first of what will be annual dermatology appointments. The dermatologist removed a possibly precancerous growth. 

I just realized that I haven’t had an eye exam since cataract surgery in 2019. Contrary to the USPSTF’s “no recommendation” for people over 65, the American Optometric Association recommends an annual exam not only to detect declines in vision but also problems like macular degeneration.

Whether they’re following the USPSTF’s lead or for another reason, our doctors may not suggest all of the tests that seem to me important for seniors to get. I’ve made my own checklist, and it doesn’t conform to the USPSTF’s nonrecommendations.