Preventive health screenings detect diseases before symptoms appear, when treatment is most effective. Regular screenings can catch cancer, heart disease, diabetes, and other conditions at stages where survival rates are dramatically higher—yet more than 20% of Americans with diabetes don’t know they have it, and more than 80% with prediabetes are unaware of their risk.
Current medical guidelines recommend specific screenings based on age, gender, and risk factors. Here are the 8 essential screenings every adult should prioritize.
Blood Pressure Screening: Starting at Age 18
High blood pressure affects 29% of U.S. adults but often has no symptoms, making it a silent killer. Blood pressure is the most prevalent and modifiable risk factor for cardiovascular diseases, including coronary artery disease, heart failure, stroke, and dementia.
When to start: Age 18
Frequency:
- Ages 40+: Annually
- Ages 18-39 with normal readings: Every 3-5 years
- Higher-risk individuals (Black adults, those with high-normal BP, overweight/obesity): Annually
Target numbers: The overarching blood pressure treatment goal is <130/80mmHg for all adults.
Why it matters: Treatment of hypertension prevents important health outcomes such as stroke, heart failure, and coronary heart disease events. Each 10mmHg increase in systolic blood pressure significantly increases cardiovascular risk.
Cholesterol Screening: Ages 20-35
Cholesterol testing identifies heart disease risk decades before symptoms appear. Elevated LDL cholesterol silently damages arteries, increasing stroke and heart attack risk.
When to start:
- All adults: Age 35
- Earlier if high-risk factors present (family history, diabetes, obesity)
Frequency: Every 3-5 years for normal results; more frequently if abnormal
What’s tested: Total cholesterol, LDL (“bad” cholesterol), HDL (“good” cholesterol), and triglycerides through a lipid panel.
Why it matters: High blood pressure is the most common and most modifiable risk factor for heart disease. Combined with cholesterol management, cardiovascular risk can be substantially reduced.
Type 2 Diabetes Screening: Starting at Age 35
Diabetes affects 13% of U.S. adults, with millions undiagnosed. Screening for prediabetes and type 2 diabetes allows early detection, diagnosis, and treatment.
Who should be screened:
- All adults ages 35-70 with overweight or obesity (BMI ≥25)
- Earlier for those with additional risk factors: family history, gestational diabetes history, PCOS, physical inactivity
Frequency: Every 3 years if results normal
Tests used: Fasting blood glucose or hemoglobin A1C
Why it matters: Preventive interventions for people with prediabetes have moderate benefit in reducing progression to type 2 diabetes, and interventions for newly diagnosed diabetes have moderate benefit in reducing risk of death. Diabetes complications—including blindness, kidney disease, and nerve damage—are largely preventable with early treatment.
Colorectal Cancer Screening: Starting at Age 45
Colorectal cancer is 90% preventable when detected early, yet screening rates remain suboptimal. The incidence of colorectal cancer in 45-year-olds today is 30 per 100,000, nearly identical to the risk in 50-year-olds in 1979 when screening first started.
When to start: Age 45 (average risk); earlier with family history or symptoms
Frequency depends on test type:
- Colonoscopy: Every 10 years
- FIT (fecal immunochemical test): Annually
- Stool DNA test (Cologuard): Every 3 years
- CT colonography or flexible sigmoidoscopy: Every 5 years
Continue through: Age 75; individualized decision ages 76-85
Why it matters: Colonoscopies not only detect disease but prevent cancer because precancerous polyps can be removed during the procedure. Recommendation rates were similar between ages 45-49 (2.8%) and age 50 (2.7%), providing strong support for guidelines recommending screening at age 45.
Breast Cancer Screening: Starting at Age 40
Breast cancer is the second most common cancer and second leading cause of cancer death in women. In 2023, an estimated 43,170 women died of breast cancer, with non-Hispanic Black women having the highest mortality rate. Screening for Breast Cancer
Updated 2024 guidelines:
When to start: Age 40
Frequency: Every 2 years through age 74
Test: Mammography (screening mammogram)
Earlier or more frequent screening for:
- Strong family history
- BRCA1/BRCA2 genetic mutations
- Dense breast tissue
- Previous chest radiation
Why it matters: The USPSTF estimated that screening starting at age 40 could save 19% more lives than starting at age 50. Finding cancer early provides more and often less-aggressive treatment options.
Cervical Cancer Screening: Ages 21-65
Cervical cancer screening has dramatically reduced deaths from this disease, but most cases occur among women who have not been adequately screened, diagnosed, or treated. Draft Recommendation: Cervical Cancer
Screening schedule:
Ages 21-29:
- Pap test every 3 years
Ages 30-65 (choose one):
- HPV test alone: Every 5 years (preferred)
- HPV test + Pap test (co-test): Every 5 years
- Pap test alone: Every 3 years
Stop screening: Age 65 (if adequate prior screening and no history of precancer)
Why HPV testing is preferred: HPV tests are more accurate and reliable than Pap tests and don’t have to be repeated as frequently. Nearly all cases of cervical cancer are associated with high-risk HPV infection.
Osteoporosis Screening: Starting at Age 65 (Women)
One in three women over 50 will experience an osteoporotic fracture in their lifetime. Osteoporotic fractures are associated with psychological distress, subsequent fractures, loss of independence, and reduced ability to perform daily activities.
Who should be screened:
- All women age 65 and older
- Postmenopausal women under 65 with risk factors:
- Family history of hip fracture
- Low body weight (BMI <21)
- Smoking or excess alcohol use
- Prolonged steroid use
- Rheumatoid arthritis
Test: DEXA scan (dual-energy X-ray absorptiometry)
Frequency: At least every 2 years; may vary based on results
Men: Consider screening age 70+ or earlier with risk factors
Why it matters: Evidence shows only 40-60% of persons experiencing a hip fracture recover their prefracture level of mobility. Medications and lifestyle interventions can significantly reduce fracture risk when osteoporosis is identified early.
Lung Cancer Screening: Ages 50-80 (Smokers/Former Smokers)
Lung cancer kills more Americans than any other cancer, but screening can detect it at curable stages. If lung cancer is found at an earlier stage when it’s small and before it has spread, it’s more likely to be treated successfully.
Who qualifies:
- Ages 50-80
- 20+ pack-year smoking history (1 pack/day for 20 years or 2 packs/day for 10 years)
- Current smokers or quit within past 15 years (USPSTF); American Cancer Society dropped the quit-year criterion
Test: Annual low-dose CT scan (LDCT)
Stop screening when: Haven’t smoked for 15+ years, serious health problems limit life expectancy, or unwilling to pursue treatment
Why it matters: These changes in guidelines mean nearly 5 million more people are now eligible for lung cancer screening each year. Early detection dramatically improves survival rates for this deadly disease.
The Bottom Line
Essential screening takeaways:
- Blood pressure: Screen annually starting at age 40; every 3-5 years ages 18-39
- Cholesterol: Begin at age 35; earlier with risk factors
- Diabetes: All adults 35-70 with overweight/obesity every 3 years
- Colorectal cancer: Start at 45; colonoscopy every 10 years or annual FIT
- Breast cancer: Mammogram every 2 years starting at age 40
- Cervical cancer: HPV testing every 5 years ages 30-65; Pap every 3 years ages 21-29
- Bone density: Women at 65; earlier with risk factors
- Lung cancer: Annual LDCT ages 50-80 for those with 20+ pack-year smoking history
Screenings save lives by detecting disease when treatment is most effective. Talk with your primary care provider about your personal risk factors and create a screening schedule tailored to your needs. Most preventive screenings are covered by insurance at no cost under the Affordable Care Act.