Health Maintenance Guidelines: 40 to 49 

Your provider will check your blood pressure, screen for healthy weight and assess your overall health. 
 

• Blood pressure: Check annually.
• Cholesterol: Check every five years.
• Diabetes: Screening depends on risk factors.
• Hepatitis C: Check at least once between ages 18 to 79.
• HIV: Check at least once between ages 15 to 65.
• Obesity: Monitor periodically throughout adulthood.
• Syphilis: Check at least once between ages 15 and 44.

• Breast cancer: Mammography should be performed annually.
• Cervical cancer screening: A Pap test should be performed every three years. Patients can get high-risk HPV testing with or without a Pap test every five years.
• Colorectal cancer: Starting at age 45, a colonoscopy should be done every 10 years, a stool fecal immunochemical test (FIT) every year or a sigmoidoscopy every 10 years with annual FIT testing. Other options – A CT colonography every five years or a FIT/DNA test every three years. 

• COVID-19: All eligible ages should receive the recommended vaccine dose and schedule per CDC, CDPH, WCHA, AAP and AAFP guidelines.
• Hepatitis B: All unvaccinated adults ages 19 to 59 years and age 60 years or older with risk factors for HBV should receive two, three or four doses of hepatitis B vaccine depending on vaccine or condition.
• Influenza (flu): Yearly vaccine.
• MMR (Measles, mumps and rubella): Adults ages 40 to 49 should have recorded in their chart at least one dose of the vaccine.
• Pneumococcal: For patients 19-49 years with certain underlying medical conditions, complete vaccine series with PCV20 only, PCV21 only, or PCV15 and PPSV23.
• Shingles: All adults age 50 and older and ages 19 to 49 with immunocompromising conditions should receive a two-dose vaccine series.
• Tdap/Td (tetanus, diphtheria and pertussis/tetanus and diphtheria): Adults younger than age 65 should receive one dose Tdap and then a Td or Tdap booster every 10 years.

• Alcohol use
• Anxiety
• Depression
• Domestic violence
• Sexually transmitted infections  
• Skin cancer  
• Tobacco use and vaping
• Unhealthy drug use  

HPV Vaccine: Can be given ages 27 to 45