Whether you actually do it or not, you probably know that just about everyone should get an annual head-to-toe check up from their primary care physician. But figuring out when to schedule the extra stuff, such as skin-cancer screenings, mammograms and bone density tests is a little more confusing.
Different tests are recommended at different ages (and some of them are gender-specific), so keeping track can feel like a part-time job — plus, guidelines are always shifting. To make things easier on you, we created this screening cheat sheet. Save it, print it and use it!
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Who Sets The Guidelines for Preventative Screenings?
Physicians (and insurance companies) follow guidelines from the U.S. Preventive Services Task Force (USPSTF), a volunteer group of experts in disease prevention, which makes recommendations for preventive clinical services based on scientific evidence.
“The USPSTF reviews each topic every five years for either an update or reaffirmation,” says Jordan Crofton, FNP, Director of Patient Care at The WELL. One Example: The USPSTF is changing the guideline process to be more inclusive. As of October 2021, the task force will consider sex and gender when making decisions, including recommendations for transgender, intersex, gender nonbinary and gender-nonconforming populations. You’ll also notice that other organizations, such as the American Cancer Society (ACS), have their own suggestions.
So, what are the current recommendations? And what are some extra credit things you can do now to stay healthy for the long term? Here, a decade-by-decade guide.
Preventative Screenings In Your 20s:
Though this is a decade when most people tend to be in pretty good health, it’s still important to get some baseline exams so your physician has something to look back on as you age.
According to the Centers for Disease Control and Prevention (CDC), 93 million U.S. adults have high cholesterol by age 20. So, in your 20s, screen your cholesterol every five years if you’re at low risk for cardiovascular disease and more frequently if you’re at high risk (determined by genetics, weight, cholesterol numbers and lifestyle factors). Ideally, at this age your total cholesterol should be less than 200 mg/dL.
Skin cancer can strike in otherwise healthy twenty-somethings. Sunburns and exposure via tanning beds in childhood and adolescence significantly increase your risk. In fact, according to the American Academy of Dermatology, melanoma (a deadly form) is the second most common type of cancer in women ages 15 to 29. Schedule an appointment with a board-certified dermatologist to do a full-body check-up once a year and to watch suspicious moles.
Sexually Transmitted Infection (STI)
“This is the most common decade to acquire STIs, some of which are associated with cancer, and many of which can last throughout your life,” says Scott Braunstein, MD, Medical Director of Sollis Health in Los Angeles.
The USPSTF recommends screenings for chlamydia and gonorrhea in all sexually active women 24 years or younger and 25 for women at increased risk of infection. Screening for human papillomavirus (HPV), the sexually transmitted infection that can cause cervical cancer, usually happens every three years with a pelvic exam and PAP smear starting at age 21.
This is a recent change from the once-a-year PAP recommendation, though many gynecologists still perform this test annually.
The American Cancer Society stopped recommending clinical breast exams and self-exams based on the lack of evidence that they help find early breast cancer. However, if you feel more comfortable checking your breasts for any new lumps and bumps, go ahead and do so. The more familiar you are with your breasts, the more easily you can detect any alarming changes.
The USPSTF doesn’t recommend regular testicular cancer screenings in adolescent or young adult men, but other experts suggest men perform their testicular self-exams (TSEs) monthly. If you notice any lumps or changes, make an appointment with your physician.
The American Optometrist Association recommends vision exams every two years between 18 and 40
Though these tests aren't always covered by insurance, they do often align with FSA/HSA coverage. You can undergo testing for food sensitivity, hormone testing and pathway-based genetic testing
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Preventative Screenings In Your 30s:
In this decade of life, you want to continue to do all of the above, plus the following:
Screenings for Genetic Cancer
“Report a family history of cancer to your doctor, as this will usually guide any early screenings you may need during this decade,” says Dr. Braunstein. For example, women at high-risk for breast cancer should start screenings at age 30, says the ACS. Likewise, a colorectal cancer screening should start ten years earlier than your relative was diagnosed.
This screening can be done every five years alone (or with your PAP smear every three years).
If you don’t have a solid exercise workout routine yet, this is the decade to establish one. Building lean muscle can help offset the natural dip in metabolism that happens with age. There are also many other health benefits: “A combination of cardiovascular exercise and resistance or weight training is recommended, and can help prevent diabetes and osteoporosis, improve your cholesterol and cardiovascular conditioning and is a natural anti-depressant,” says Dr. Braunstein.
Preventative Screenings In Your 40s:
See the recommendations for 20s and 30s and add in the following screenings:
The American Optometrist Association recommends vision exams every two years between 18 and 40. If you haven’t been doing that, now is a great time to start. The recommendation for 41 to 64 remains the same, with annual checks if you’re at high risk of eye issues. “This is the age when most people will begin to need reading glasses,” says Dr. Braunstein. But it’s not just about being able to enjoy a novel at bedtime or even detecting degenerative eye disease such as glaucoma —your eyes are the windows to health and can illuminate many diseases.
The USPSTF recommends mammograms every other year for women 50 and over, but you have the choice to start at 40. The American Cancer Society suggests women 45 to 54 get mammograms once a year.
Colorectal Cancer Screenings
The USPSTF recently changed the recommendation for colorectal cancer screening from age 50 to 45. “The most thorough test is a colonoscopy, but other options are available, including newer stool DNA testing, depending on your risk status,” says Dr. Braunstein. Discuss which screening is best for you with your doctor.
This is the decade to start screenings for pre-diabetes and Type 2 diabetes. When going in for a diabetes screening, expect a blood test.
Clean up your diet — and exercise portion control. Weight can add up over time and increase your risk for cancer and heart disease.
Preventative Screenings In Your 50s+:
In your 50s, the frequency of earlier screenings may increase. Here are the must-dos:
At age 55, the recommendation moves to every two years or you can continue to have one annually.
Starting at age 64, eye and vision exams should be done annually due to increased risk of Glaucoma, cataracts or other vision deficiencies.
Prostate Cancer Testing
The ACS recommends this screening, done via a blood test looking for prostate-specific antigen (PSA), for men ages 50+ with average risk. The USPSTF says prostate screening is an individual decision for men ages 55 to 74.
Lung Cancer Screening
Low-dose chest C.T. has recently been recommended for those with a history of smoking, says Dr. Braunstein. The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
Bone Density Testing
Bone density testing is recommended for women between the ages of 50 and 65 with risk factors of osteoporosis and who are postmenopausa. From there, the USPSTF suggests bone density screenings for women starting at 65 years old.
Extra Credit At Any Age
It’s never too late to start enforcing these good habits, says Crofton.
- Quit smoking.
- Cut out added sugar and processed foods.
- Improve sleep hygiene (limiting screen time before bed, reducing caffeine, sleeping in a dark room, etc.) to optimize deep sleep.
- Get exercise — a mix of weight-bearing activities for bone health, cardio and stretching.
- Do genetic testing through a Functional Medicine Practitioner. It’s a great way to better tailor your diet and lifestyle to your genes specifically, says Crofton.