As we grow older, our risk for certain diseases and health conditions changes. Preventive health screening by committing to regular check-ups and screening tests help to spot warning signs early on. And in general, the earlier a health condition is detected, the easier it is to treat.
Health screenings are important for people of all ages, but the screening tests may vary based on your age, gender, family history and overall health. Some screenings are done on annual basis, but there are some that should be performed more frequently.
So, when should we start health screenings for certain health conditions like cholesterol, diabetes, cancer and more? What vaccines should I be getting at my age? To help answer all these and more. Here is a guide to help you keep track of recommended routine screenings, arranged by age and gender:
AGES 18-39
- History and physical exam (both men and women): should be performed every one to two years for adults ages 19-49, and every year for adults ages 50 and older.
- BMI monitoring (both men and women): annually
- Cholesterol check (both men and women): completed in your twenties, and then annually once you turn 35; it will be checked every five years if normal, annually if you have risk factors.
- Skin check (both men and women): monthly skin self-exam, specifically to check for any suspicious mole or skin lesion, then by a doctor every 3 years, starting at age 20.
- Breast exam (for women): clinical breast exam should be done every 1–3 years to check for breast lumps.
- Pelvic exam (for women): annually.
- Cervical screening (for women): involves tests for cervical cancer such as pap smear and an HPV test. A pap smear should be conducted for sexually active women who are ages 21-30 every 1-3 years. While women who are 30 to 65 have three options for testing: a pap test and an HPV test (co-testing) every 5 years, a pap test alone every 3 years or they can have HPV testing alone every 5 years.
- Ovarian screening (for women): ovarian cancer screening may be recommended, starting at age 30 to 35, or 5 to 10 years earlier than the age when the youngest family member was diagnosed. Screening may include a blood test for CA 125 and a pelvic ultrasound (transvaginal ultrasound).
- Testicular exam (for men): monthly testicular self-exams should begin at puberty and continue throughout adult life to evaluate for testicular cancer. It also should be done annually by a doctor as part of an annual physical exam.
- Blood pressure test (both men and women): at least every 2 years, unless diagnosed hypertensive.
- Eye exam (both men and women): at least one exam from ages 20-29 and at least two exams from ages 30-39. This is done to test for vision, glaucoma and macular degeneration.
- Hearing test (both men and women): starting at age 18, then every 10 years, if normal.
- Thyroid test (both men and women): start at age 35, then every 5 years if normal.
- Cholesterol test (both men and women): start at age 20, then every 5 years if normal.
- Dental exam (both men and women): one to two times every year.
- STI and HIV screening (both men and women): starting at the age of 18, regular testing for sexually transmitted infections, including HIV, is based on sexual activity and other risk factors.
- Immunizations:
- Influenza/Flu: Yearly
- Tetanus-Diphtheria Pertussis Booster vaccine: every 10 years
- Human papillomavirus vaccine (HPV): a three-dose series (0, 1-2, 6 months) for persons who initiate vaccination at ages 15 through 45 years, and for immunocompromised persons.
AGES 40-49
The screenings in the 18 – 39 age group should be followed as was discussed above or as recommended by your physician.
- Mammograms (for women): start the age of 40 and should be done every 1-2 years; if breast cancer runs in your family or you have other risk factors, you may need to begin regular mammograms at an earlier age.
- Diabetes (both men and women): blood sugar test (FBS and Hba1C) should start at age 45, then every 3 years, if normal.
- Eye exam (both men and women): get an exam at age 40, then every 2–4 years or as your doctor advises.
- Colonoscopy (both men and women): should be completed at age 45 or ten years earlier than the youngest family member with colon cancer; with normal results, colonoscopy should be completed every 10 years and normal stool screenings should be repeated annually.
- Prostate screening (for men): includes digital rectal exam and PSA blood test, can start at age 40 if you are considered a high-risk individual (ex. Family history of prostate cancer) or at age 45 for men with known BRCA2 mutations (gene for prostate cancer).
- Immunizations:
- Pneumococcal vaccine: for high-risk groups, such as patients suffering from alcoholism. chronic heart, lung, kidney, or liver disease.
AGES 50-64
Again, many of the screenings aforementioned should still be done as per the screening guidelines set. But at age 50 onwards, a few more screening tests should be done:
- Fecal occult blood test (for colorectal health): for both men and women, should be done annually.
- Flexible Sigmoidoscopy (with fecal occult blood test is preferred): another screening test for colorectal cancer, this should be done every 5 years (if not having a colonoscopy).
- Colonoscopy (both men and women): every 10 years, if normal.
- Hearing test (both men and women): from every 10 years to every 3 years when you hit the age of 50 onwards.
- Prostate screening (digital rectal exam): as screening for prostate cancer, this should be done every 5-10 years with each colorectal screening.
- Prostate-Specific Antigen (PSA) blood test (for men as part of prostate screening): general guidelines recommend starting at age 55. Men who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years. While screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
- Bone density study (for men and women): may start at the age of 60 if you’re in a high-risk population such as women, men with low testosterone levels, smokers, alcoholism, and certain chronic conditions such as rheumatoid arthritis, Crohn’s disease, and thyroid disorders.
- Lung cancer screening (both men and women): 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 should have an annual chest CT scan.
- Immunizations:
- Herpes zoster vaccine (to prevent shingles): starting at age 60, a one-time vaccination with the option of a booster shot given 2-6 months after the initial dose for individuals aged 60 years and older.
AGES 65 and older
In addition to the screening tests mentioned above, there are a few more that you should start at the age of 65:
- Bone density study (form men and women): starting at the age of 65, men and women should have a bone density study every 2 -5 years.
- Eye exam (both men and women): from every 2-4 years, people at age 65 years and older should have an exam performed more often, at every 1-2 years.
- Abdominal aortic aneurysm screening (both men and women): a one-time screening for abdominal aortic aneurysm (AAA) is recommended via ultrasonography in men aged 65 to 75 years who have ever smoked.
- Immunizations:
- Pneumococcal vaccine: One time each of two different vaccines.
FINAL THOUGHTS
Preventive health screening is important because it can help identify potential health problems early, when they may be easier to treat. Some of its advantages include early detection of diseases, identification of risk factors for certain diseases and improving health outcomes and ultimately improving the quality of life. Lastly, health screenings can also provide peace of mind, or reassurance that their health is on track or if not, give them a head start to address any issues discovered.
It’s important to remember though that health screenings should be part of an overall preventive care plan, one that includes a healthy lifestyle and regular check-ups with a healthcare professional.
About The Author
Dr. Hannah is a highly-skilled and compassionate physician who completed her medical degree at Pamantasan ng Lungsod ng Maynila in 2014. She passed the Physician Licensure Exam in 2015, and has since gained experience working in various hospitals and clinics throughout Metro Manila. For three years, she served as a physician on duty at a dialysis institute, caring for patients with chronic lifestyle diseases.
As a primary care physician, Dr. Hannah is dedicated to providing patient-centered care that takes into account the whole person, not just their illness. She believes in empowering her patients to take an active role in their healthcare, and believes that this type of doctor-patient relationship is key to achieving optimal health.
