Some of these evaluations include screening for colon cancer, osteoporosis, cervical cancer (PAP tests), and breast cancer (mammograms). Immunizations are not just for little children; adults need protection from infection as well. Below is information to help you when discussing with your doctor or nurse practitioner.
INFLUENZA VACCINE Influenza vaccine is recommended yearly for all adults in the fall or winter. The vaccine may be given as soon as it becomes available. [pdf]
PNEUMOCOCCAL VACCINE Pneumococcal vaccine is recommended for all adults 65 and over and for those younger than 65 who have chronic illness or risk factors such as heart, liver or lung disease including asthma, cigarette smoking, alcoholism, and people with cochlear implants. It is also recommended in those with highest risk of fatal pneumococcal infection (people without a spleen, people with an immuno-compromised condition such as HIV infection or leukemia or lymphoma, or those on chronic steroid medication).
The recommended schedule to receive the vaccination is to get one (1) dose, if unvaccinated. With a one-time revaccination, if age 65 and older and, if first dose was given prior to age 65 and 5 years has elapsed since dose #1. Those with highest risk of fatal pneumococcal infection are to get revaccination if age 19-64 and 5 years have elapsed since dose #1. [pdf]
TETANUS / DIPHTHERIA OR TETANUS / DIPHTHERIA / PERTUSSIS VACCINES Td (Tetanus-diphtheria vaccine) or Tdap (Tetanus-diphtheria-a cellular Pertussis vaccine) is recommended in all people who lack written documentation of a primary series consisting of at least 3 doses of tetanus- and diphtheria-toxoid-containing vaccines. Tdap vaccine is recommended in adults younger than 65 who have not received Tdap and in those 65 and over who have contact with infants younger than 12 months. Adults 65 and over may receive the vaccine whether they have contact with infants or not. Td vaccine is recommended every 10 years [pdf]
ZOSTAVAX VACCINE Zoster (shingles) vaccine is recommended for adults 60 and over if unvaccinated regardless of history of chickenpox or shingles. [pdf]
MMR VACCINE MMR (Measles, mumps, rubella vaccine) is recommended for people born in 1957 or later if there is no lab evidence of immunity or documentation of dose given on or after 1st birthday. People in high risk groups such as healthcare personnel and students entering college and international travelers should receive a total of 2 doses. Women of childbearing age who don’t have evidence of rubella immunity or vaccination should receive the vaccine. [pdf]
VARICELLA VACCINE Varicella (Chicken pox) vaccine is recommended for those adults without evidence of immunity (evidence of immunity can be based on health care provider diagnosis of varicella disease or herpes zoster, history of receiving 2 doses of varicella vaccine or lab evidence of immunity). [pdf]
HEPATITIS A VACCINE Hepatitis A vaccine is recommended for anyone who wants to be protected from hepatitis A infection. It is recommended for people who travel or work anywhere except US, Canada, Western Europe, Australia, New Zealand and Japan. It is recommended for those with chronic liver disease, drug users, men who have sex with men, people who receive clotting factor concentrates. [pdf]
HEPATITIS B VACCINE Hepatitis B vaccine is recommended for anyone who wants to be protected from hepatitis B infection. It’s also recommended for household contacts and sexual partners of those who are HBsAg-positive, sexually active people not in long-term mutually monogamous relationships, men who have sex with men, diabetics younger than 60, healthcare personnel and public safety workers who are exposed to blood, staff working with developmentally disabled, certain international travelers, and people with chronic liver disease. [pdf]
POLIO VACCINE Polio vaccine is recommended only in people who intend to travel to areas where exposure to wild-type virus is likely. [pdf]
MENINGOCOCCAL VACCINE Meningococcal vaccine is recommended in people who lack a functioning spleen or who travel to or reside in countries in which meningococcal disease is more common (subSaharan Africa). It is also recommended for 1st year college students through age 21 who live in residence halls. If student received most recent dose when younger than 16, then booster dose is recommended at age 19-21. [pdf]
Colon cancer is the 3rd most common cancer in the United States, and the 2nd most common cause of cancer related deaths. Many of these are preventable. Most colon cancers develop from certain types of polyps (adenomas); these types of polyps can grow in up to 30% of people over age 50. The risk for these polyps goes up with age. Some patient populations are also at higher risk for polyps.
Please discuss with your health care provider which of these options would be best for you.
Osteoporosis Screening Recommendations: Should you get a DEXA scan?
Osteoporosis is a condition of decreased bone strength, with increased risk for fractures. Women become more likely to have this, or its milder version, osteopenia, after menopause. Prevention and treatment are available, and a screening Xray test (DXA or DEXA) is recommended for all women over age 65 and for women over 60 with increased risk factors.
DEXA scanning is available for all our patients, with studies done at our clinics in North Portland, Oregon City, and Tigard. Please ask your health care professional if you would benefit from this test.
The Papanicolaou Smear is a microscopic evaluation of cells from a woman’s cervix. This Cytology screening test looks for abnormalities that may suggest cancer or pre-cancer conditions. The United States Preventive Services Task Force (USPSTF) strongly recommends screening for cervical cancer in women who have ever had sex and have a cervix. The American Congress of OB/Gyn recommends Pap screening begin at age 21, if normal, continue every 2 years between the ages of 21 – 29; every 3 years after age 30 (if low risk and 3 tests in a row were normal). The American Academy of Family Physicians and the USPSTF recommend screening every 3 years. If Pap tests have recently been adequate and normal, the USPSTF recommends against routinely screening woman older than age 65 that are not otherwise at high risk for cervical cancer.
In November 2009, the US Preventative Services Task Force (USPSTF) made new recommendations for screening mammograms; with much discussion by the medical community, these were revised in December 2009. Their current recommendations are for routine mammogram screening to begin for women at age 50, with every 2 years mammogram up to age 74. Women should discuss with their medical care provider if Mammography would be appropriate during ages 40 – 50, if should be done yearly for ages 50 – 74, or if screening should be continued after age 75. Some medical groups agree with these recommendations (American Academy of Family Physicians), while others urge regular mammograms yearly starting at age 40, closer to the previous recommendations (American Cancer Society -ACS). Please discuss with your doctor or NP what makes sense for you.