The S&P 500 extended its winning streak for 2018 on Monday although its advance slowed to a crawl as the health care and financial sectors weighed it down and investors awaited the start of the quarterly earnings season.

The health care sector was the S&P's worst performer on Monday, and investors were cautious about pouring money into bank stocks before the companies kick off the fourth-quarter earnings season later this week.

"We had a big move last week and everyone knows earnings is coming up. People don't want to chase too much further when you have a round of fundamental inputs in the next few weeks," said Michael O’Rourke, chief market strategist at JonesTrading in Greenwich, Conn.

The Dow Jones Industrial Average fell 12.87 points, or 0.05 percent, to 25,283, the S&P 500 gained 4.56 points, or 0.17 percent, to 2,747.71, and the Nasdaq Composite added 20.83 points, or 0.29 percent, to 7,157.39.

The three major indexes kicked off 2018 with their strongest first four trading days in more than a decade, according to Reuters data. The Dow had its strongest start since 2003, and the Nasdaq and S&P 500 had their strongest starts since 2006.

Historically, the first five trading days of January can be an indicator for the market's direction for the full year, according to the Stock Trader’s Almanac.

The S&P 500's health-care sector ended 0.4 percent lower. Last week it rose 3.2 percent.

The Nasdaq biotech index fell 1.4 percent, on track for its biggest one-day percentage decline since mid-December, led by a 3.7 percent drop in Biogen Inc and a 3.3 percent decline in Regeneron Pharmaceuticals Inc.

A 0.4 percent decline in the bank subsector pressured the broader financials index, which fell 0.1 percent. Investors were waiting for more details about the impact of recent U.S. corporate tax cuts in fourth-quarter earnings calls when the reporting season begins later in the week.

Wells Fargo and Citigroup fell more than 1 percent while Goldman Sachs declined 1.5 percent. Most big U.S. lenders have estimated one-off charges to their fourth-quarter earnings on account of U.S. tax cuts.

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