Preventive Screenings by Decade

Preventive screening is the set of tests done when you feel fine. The point is to find problems at the stage where treatment is easy and cheap. Most of the tests below come from the US Preventive Services Task Force (USPSTF), which grades the evidence behind each one, and from the major specialty societies. Guidelines change. Ask your clinician which apply to you.

The tests are grouped by the decade they usually start. Once a test starts, it continues at its interval unless noted.

Every adult, every decade

Blood pressure. At least once a year at a visit, more often if it runs high. Home readings count and are often better. See how to take blood pressure at home.

Weight and waist. Tracked at each visit. Not a diagnosis, but it sets the schedule for other tests.

Cholesterol. A lipid panel starting in the 20s for most adults, then every four to six years if normal and risk is low. More often with risk factors. See the cholesterol panel explained.

Hepatitis C. Once for every adult between 18 and 79. A blood test. Most people with chronic hepatitis C do not know they have it, and it is now curable.

HIV. At least once for everyone between 15 and 65. More often with ongoing risk.

Depression and anxiety. A short questionnaire at visits. Cheap and worth doing.

Dental and eye exams. Not USPSTF territory, but yearly dental cleanings and a baseline eye exam by 40 are standard advice.

20s

Cervical cancer screening begins at 21 for anyone with a cervix. A Pap test every three years from 21 to 29.

Sexually transmitted infection screening for chlamydia and gonorrhea is recommended yearly for sexually active women under 25 and for anyone with new or multiple partners.

Skin checks are a good habit to start. The USPSTF finds the evidence for routine full body skin exams uncertain, but knowing your own moles is free.

30s

Cervical screening continues. From 30 to 65 the options are an HPV test every five years, a combined HPV and Pap test every five years, or a Pap alone every three.

Diabetes screening begins at 35 for adults who are overweight or obese, per USPSTF, and the American Diabetes Association recommends it for all adults at 35. Repeat every three years if normal. See diabetes screening explained.

40s

Breast cancer. The USPSTF now recommends mammography every two years from 40 to 74. Some societies recommend yearly. People with a family history or dense breasts may start earlier or add other imaging.

Colorectal cancer. Screening starts at 45. Options range from a yearly stool test done at home to a colonoscopy every ten years. See colorectal screening options.

Diabetes. If not already started, it starts now for most people.

Kidney function. Not a routine screen for healthy adults, but anyone with diabetes or high blood pressure should have a yearly urine albumin test and a blood creatinine test. See kidney health urine tests.

50s

Lung cancer. A yearly low dose CT scan from 50 to 80 for people with a 20 pack year smoking history who currently smoke or quit within the past 15 years. A pack year is one pack a day for one year.

Prostate cancer. PSA blood testing from 55 to 69 is an individual decision. The test finds cancers that would never have caused harm as well as ones that would. Talk it through before ordering it.

Shingles vaccine. Two doses at 50 or older.

Colorectal and breast continue.

60s and beyond

Osteoporosis. A bone density scan for women at 65, and earlier for anyone with risk factors. For men the evidence is less settled.

Abdominal aortic aneurysm. A one time ultrasound for men 65 to 75 who have ever smoked.

Pneumonia and other vaccines. Pneumococcal vaccination at 65. Flu yearly. COVID per current guidance.

Fall risk and hearing. Asked about at visits. Cheap to fix, expensive to ignore.

Cervical screening can stop at 65 after adequate prior negative tests. Colorectal screening is individual from 76 to 85. Mammography guidance runs to 74 with individual decisions after.

How to use this list

Print it or save it. Check off what you have had and when. Bring the gaps to your next visit. The most common reason a screening gets missed is not refusal. It is that nobody brought it up.

Home tests fill some gaps between visits. Blood pressure, blood sugar, urine albumin, and stool tests for colorectal screening can all be done at home. They do not replace the visit. They make the visit shorter.