Preventive Health Screenings Every Adult Should Consider

Getting a complete, annual physical is the most important thing you can do to remain fit and healthy, yet far too many Americans see a health care provider only when they’re sick, missing out on the many ways modern medicine can detect and even prevent illnesses.

When you see your provider because you’re ill, that visit will focus on treatment. But when you have an annual exam, the focus is on preventing illness through an array of medical tests that screen for diseases and health conditions that have yet to present symptoms.

Many routine measurements – blood pressure, body weight and cholesterol count, for example — collect data your health care provider uses to screen for likelihood of related conditions — heart disease, for example. Knowing you are on a path to heart disease can lead to dietary, exercise and other lifestyle changes to help you minimize or avoid it.

Other tests – for example, mammograms and Pap tests for women and prostate tests for men — can identify cancer that is still asymptomatic, allowing for quick, early treatment.

So what should you be screened for and when? The options are many and often depend on your age, sex, lifestyle and other risk factors, but here are the basics every adult should have.

Basic Screenings

Beginning at age 18, you should have an annual physical exam that includes taking your blood pressure with an inflatable cuff and a calculation of body mass index (BMI) based on height and weight.

These measurements will help your provider evaluate your likelihood for future cardiovascular problems. Knowing at a young age that you are setting the stage for illness when you are older should provide motivation for weight loss, a healthier diet and greater activity levels now that could change your future.

Additionally, your annual physical exam will include a review of your vaccinations, one of the most important preventive health measures you can take. While many vaccinations are given in childhood, adults need an annual flu shot and periodic boosters of the COVID, flu and Tdap (tetanus, diphtheria and whooping cough) or Td (tetanus, diphtheria) vaccines. As you age, additional vaccines can protect you from pneumonia, shingles and the respiratory disease RSV.

Some screenings are needed for all adults but not annually. That includes a blood test called a lipid profile to check cholesterol levels, which is usually recommended every five years unless you smoke, have diabetes or have a family history of heart disease, in which case this test should be performed more frequently. Women should be screened every three years for cervical cancer through a Pap test performed during a pelvic exam.

Health care providers also recommend screening for HIV, the virus that causes AIDS, and for other sexually transmitted diseases for patients who are high risk or who have been previously diagnosed with an STD.

For the most part, women should begin getting an annual mammogram screening at age 40.

But with an increasing occurrence of breast cancer in younger women, that advice may be changing. Ask your health care provider if you need a mammogram at an earlier age, especially if your mother or sister had breast cancer at a young age or you carry a high-risk genetic marker.

Screening Tests as You Get Older

As you age, the schedule for some basic screening tests will become more frequent since disease occurrence increases with age. Additionally, both men and women in their 40s should have a baseline colonoscopy to screen for colon cancer. And all women in their 40s should begin having a mammogram once a year.

From ages 35 to 70, if you are overweight or obese, you should have an annual screening for pre-diabetes or diabetes. Around age 45, everyone should be screened for diabetes every three years with one or more of these tests:

• An A1C test that measures your average blood sugar level over the past several months;
• A fasting blood sugar test that measures blood sugar after an overnight fast;
• A glucose tolerance test that measures blood sugar before and after you drink a liquid containing glucose.
• A random blood sugar test that measures blood sugar at the time tested (without a fast).

When they reach 50, women should have a bone density test (men should have this test only as needed or recommended.) At age 50, men should be screened for prostate cancer as needed and recommended (earlier if there is a family history). Beginning in your 60s, both men and women should be screened annually for dementia or Alzheimer’s.

Other Important Screenings

In addition to your annual physical, you should also see be screened every six months by a dentist, who can detect oral cancers, prevent or treat gum disease and fill or remove cavity-filled teeth. This is important because poor oral health is associated with other chronic diseases such as diabetes and heart disease.

The American Academy of Ophthalmology recommends healthy adults without vision problems receive a comprehensive eye exam in their 20s followed by two exams in their 30s and follow-up exams every two to four years after that to age 54, when the frequency should increase to every one to three years. Because of increased risk for cataracts, glaucoma and macular degeneration, adults over age 65 should have an eye exam every one to two years.