Health screenings by age, and why they’re not worth skipping

Nurse measuring patient’s blood pressure

Whether you’ve postponed health care because of the COVID-19 pandemic or another reason, it’s always a good time to get your recommended screenings and other medical care back on track.

The risk of skipping health screenings or annual wellness visits

When you skip or postpone health screenings, you could delay detecting disease. Some screenings allow doctors to treat diseases early, before they cause organ damage. For example, after discovering high cholesterol, a health care provider could help you lower it to prevent a heart attack and stroke. In the case of cancer, early diagnosis means we might catch it at a more easily treatable stage.

Screening recommendations vary based on gender and your personal and family health history. It’s important to discuss your screening options with your doctor, but here are some basic guidelines:

Blood pressure

All adults should be screened for high blood pressure.

Adults 18 to 39 with normal blood pressure: If you don’t have other risk factors, you should be screened at least every three to five years.

Adults 40 and over, and those at increased risk of high blood pressure: You should be screened annually.

Cholesterol

Adults age 20 to 40: The American Heart Association recommends cholesterol screening every five years.

Adults 40 to 75: The U.S. Preventive Services Task Force (USPSTF) recommends screening every five years, and more frequent screening of those patients at risk of developing heart disease.

Diabetes

Adults ages 35 to 70 with BMI greater than 25: The USPSTF recommends screening for type 2 diabetes or prediabetes every 3 years if normal.

Adults who are overweight, have high blood pressure or other risk factors: The American Diabetes Association recommends screening. The American Diabetes Association also recommends screening ALL adults over 45 years of age.

Hepatitis C

Starting March 2020, the USPSTF recommends screening all adults for hepatitis C at least once, and more often if at risk.

HIV

Everyone ages 15 to 65: Screening for HIV is recommended for everyone at least one time. Repeat screening is advised for people with an increased risk of HIV infection and with each pregnancy. People at risk for getting HIV may also benefit from medication to prevent HIV called preexposure prophylaxis (PrEP).

Depression

All adults and children starting at age 12 should be screened for depression. The American Academy of Pediatrics recommends yearly screening from 12-21 and targeted screening for kids 10 and up who are at high risk.

Colorectal cancer

In general, individuals who are 45 and older should be screened for colon cancer. If you have family history, you may need to be screened earlier, so please discuss this with your doctor. The screening interval depends on what kind of screening you choose and what the results are.

Skin cancer

Currently, there’s no recommended routine skin cancer screening of patients without symptoms. You should screen yourself by looking for new spots, growths, changing moles and other lesions, and alert your doctors to any concerns. That being said, skin cancer is very common and can often be prevented with sun protection. Learn more about the ABCDEs of skin cancer when doing a self-check. Kids and young adults with fair skin are at particularly high risk for skin cancer and should minimize ultraviolet radiation exposure.

Breast cancer

All women 40 and older should start discussing breast cancer screening with their physician to decide if screening should start based on personal preference and the trade-off between benefit and harm. The expert guidelines vary in recommendations between ages 40 and 49, which is why it’s important to discuss your plan with your doctor. Women 50 to 74 should be screened every one to two years by mammography. Additionally, women with risk factors such as family history, BRCA mutation or chest radiation should talk with their physician about when to start screening. Most medical organizations no longer recommend clinical breast examinations as part of screening.

Cervical cancer

Cervical cancer screening guidelines have changed a lot during the past 20 years. Screenings are now recommended for women between the ages of 21 and 65, unless they’ve had a hysterectomy. There are two main ways to test. The first is a traditional pap smear. The second is high-risk human papillomavirus (hrHPV) testing. The latter looks for the virus that causes cancer. The two can be used independently or combined as a co-test.

Between the ages of 21 and 29: You should get the pap smear alone every three years.

Women 30 and older: Continue getting pap smears every three years, or get the hrHPV test alone or co-testing every five years.

If you’ve been receiving regular screening that has been normal, you can discontinue screening after age 65. A vaccine that prevents cervical cancer is now available to women up to age 45.

Bone density

All women over 65 should be screened for osteoporosis or low bone density.

Postmenopausal women under 65 who have risk factors should also be screened. You should discuss this with your doctor if you are at risk.

Prostate cancer

Starting at age 50, all men should have a discussion with their doctor about the risks and benefits to determine if they should screen with a prostate specific antigen (PSA) blood test. Men with risk factors for prostate cancer, including Black men and those with family history, should start the discussion at age 40.

Testicular cancer

The USPSTF recommends not screening for testicular cancer. Testicular cancer is usually found by men themselves or by their partners, and screening hasn’t been found to be helpful.

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