What's a Woman to Do? Well...
Follow this checklist to keep your body humming. Pssst, gents! Some of this applies to you too.
By Jean Chatzky


• WHAT TO EXPECT Strokes, heart attacks and other cardiovascular traumas claim the lives of 500,000 women each year--as many as the next six killers of women combined. Some factors you can't control. Heredity. Aging. But living clean--exercising regularly, maintaining a healthy weight--can tip the scale in your favor. Smoking just one to 14 ciggies a day can triple a woman's risk. Butt out, indeed.

• MUST-HAVE TESTS Blood-pressure screening at least once every two years for women 18 and older. More frequently if your pressure is above 130/85.

• OPTIONAL TESTS EKG to track patterns in heart activity once a year. COST: $54 C-reactive protein blood test (for inflammation; see page 120). COST: $60 Homocysteine blood test (for plaque and calcification). COST: $50


• WHAT TO EXPECT No one knows what causes breast cancer. But we can identify one of the top risk factors: simply getting older. Among women 40 to 49, there's a one-in-66 chance of developing breast cancer; 50 to 59, the risk increases to one in 35. Don't like those odds? Time to become a screen queen.

• MUST-HAVE TESTS Mammogram every one or two years starting at age 40. (Digital versions of the test allow images to be sent electronically for a second opinion.) COST: $85 TO $155

• OPTIONAL TESTS Ultrasound as a follow-up for women with dense breasts to see whether masses are solid or cystic. COST: $200 TO $250 Baseline mammogram at 30 for women with a mother or sister with breast cancer.


• WHAT TO EXPECT Your bones reached their peak strength by the time you hit 30. Ever since, you've been gradually losing bone mass and increasing your risk for fractures. Men are on the same clock, but once women hit menopause, their decrease in estrogen production speeds the process. That's why osteoporosis is considered a women's disease.

• MUST-HAVE TESTS DXA scan every other year beginning at age 65. Start at 60 if you smoke, have had a fracture, have a family history of fractures or weigh less than 150 pounds. COST: $130

• OPTIONAL TESTS DXA scan at 45 as a baseline if you've had a fracture.


• WHAT TO EXPECT A rare area in which risk declines with age (largely because cervical cancer is linked to high-risk sexual behavior, which tends to decline with age). Once you reach 65, if your past three Pap smears were negative, you don't need to be tested again. Many doctors prefer liquid Paps because the same sample can be tested for HPV (human papillomavirus), a potential indicator of cervical cancer. No good screens exist for ovarian or uterine cancer.

• MUST-HAVE TESTS Pap smear every three years for women over age 21 or those who are sexually active. COST: $35 TO $65

• OPTIONAL TESTS Annual Pap smear (many doctors and 75% of women say they feel safer screening annually).


• WHAT TO EXPECT As you age and fatten, the level of bad cholesterol in your blood tends to rise. And menopause chips away at the good cholesterol. If you're overweight--in the U.S., an estimated two-thirds of both women and men over 40 weigh too much--that sends your risk of clogged arteries higher still. Smoker? Family history of heart disease before 60? Both? Your arteries might need Drano any day now.

• MUST-HAVE TESTS Lipid measurement, including total cholesterol and high-density lipoprotein (HDL) cholesterol measurement, every five years for women 45 and up. (More frequent testing should start at age 20 for high-risk patients.) COST: $12

• OPTIONAL TESTS Thyroid for hypothyroidism (up to 10% of women contract this slowdown of the thyroid gland, which can cause weight gain). COST: $20 TO $35 Glucose for diabetes. COST: $6


• WHAT TO EXPECT The more sun in your freckled life--especially as a kid--the greater your long-term risk of skin cancer. Women (and men) over 65 and people with more than 50 moles should be on special guard. It appears that women under 40 should now be extra-cautious as well. A recent Mayo Clinic report says non-melanoma skin cancers have doubled in young women since the 1970s. Doctors suspect tanning beds (which teenage girls bake in three times as often as teenage boys) may be to blame.


• OPTIONAL TESTS Annual skin exam by a dermatologist or general practitioner, including inspection of the scalp, the area between the toes and the bottom of your feet. COST: ONE OFFICE VISIT

NOTES: MONEY's "must have" tests have an A or B rating from the U.S. Preventive Services Task Force. "Optional" tests are widely recommended by experts. Cited costs are based on Medicare reimbursement rates or doctor estimates. The amount that private insurance and patients pay varies according to state regulations and many other factors.