Massachusetts Department of Developmental Services Annual Health Screening Recommendations
For use at the annual health visit
Intended to guide self-advocates, families, and support providers in discussing individual screening exams with a physician or Health Care Provider (HCP)
Name: ___________________________Age:______
Date
of last
screen
All Adults
All Adults
Height/Weight/BMI
Colorectal Cancer
screen
Skin cancer screen
Hypertension
Cholesterol
Diabetes
(Type II)
Osteoporosis
Dysphagia and
Aspiration
STDs
HIV
Hepatitis B & C
Tuberculosis
Depression
Dementia
Men
Testicular exam
Prostate cancer
screen (PSA or
DRE)
Annually.
Annual Fecal Occult Blood Testing ages 50+ OR
FOBT + Sigmoidoscopy every 5 years ages 50+ OR
Colonoscopy every 10 years at ages 50+, per HCP
recommendation or if above screens not performed.
Total skin examination every 3 years from 20 39.
Annually age 40 and older.
At least annually.
Every 5 years or at HCP discretion.
HgbA1c or fasting plasma glucose screen at least
every 5 years until age 45 if at high risk. Every 3
years after age 45.
Consider Bone Mineral Density (BMD) testing ages
19-59 when risk factors are present (including
medications, mobility impairment, hypothyroid). BMD
testing for others age 60-65.
Assess for swallowing problems and symptoms of
GERD annually.
Screen annually, if at risk.
Periodic testing if at risk.
Periodic testing if at risk.
Skin testing every 1-2 years for individuals at risk.
Screen annually for sleep, appetite disturbance,
weight loss, general agitation.
Monitor for problems performing daily activities.
Annually
Discuss risks and benefits of screen age 50-75, based
on presence of symptoms and clinician/patient
discretion; Discuss screen age 40-49 if at risk.
Women
Clinical breast exam
Mammography
Annually
Annually ages 50-69; earlier at HCP discretion.
Pap Smear
Every 2 years through age 29 and every 3 years ages
30-65, depending on risk factors.
Ask HCP to
evaluate need
for screening
Date: _______________
Last Date
Ask HCP
Immunizations
Tetanus-diphtheria (Tdap)
Influenza vaccine
Pneumococcal vaccine
Hepatitis B vaccine
HPV Vaccine
Three doses given once. TD booster every 10 yrs.
Annually.
Once (booster at age 65).
One series of 3 vaccinations. Reevaluate antibody
status every 5 years.
Three doses for unvaccinated adults aged 9-26.
Vision and Hearing
Eye Examination
Hearing Assessment
All should be under an active vision care plan and
eye examination schedule based on
recommendations from an ophthalmologist or
optometrist.
Includes a glaucoma assessment at least once
by age 22.
People with diabetes should have an annual
eye exam.
Annually. Re-evaluate if hearing problem reported
or change in behavior noted.
General Counseling and Guidance
Prevention Counseling
Abuse or neglect
Healthy Lifestyle
Preconception counseling
Menopause management
Annually. Accident/fall prevention, fire/burns, choking.
Annually monitor for behavioral signs of abuse and neglect.
Annually. Diet/nutrition, physical activity, & substance abuse.
As appropriate. Genetic counseling, folic acid supplementation,
discussion of parenting capability.
As appropriate. Counsel on change and symptom management
Other Populations
Persons with Down
Syndrome
Thyroid function test every 3 yrs (sensitive TSH)
Obtain baseline of cervical spine x-ray to rule out
atlanto-axial instability; recommend repeat if
symptomatic, or 30 years from baseline.
Baseline echocardiogram if no records of cardiac
function are available.
Annual screen for dementia after age 40
Annual liver function test.
Hepatitis B Carriers
Other Screening to be considered at this appointment: (This may include tests
recommended previously or by other clinicians that have not yet been performed)
Screening Recommendations based on Massachusetts Health Quality Partnership (MHQP) Adult Preventive Care Recommendations 2010/11
FORM HC-1 Revised March 2012
