7 health screenings you need beyond your annual physical
Find out which preventive tests can help you stay well, plus how to fit them all into your schedule.
Like many people, you probably schedule an annual physical with your doctor. These exams are a great way to get a sense of your health now. They can also help your physician find any health risk factors and create a personalized prevention plan. But checking the annual checkup box doesn't necessarily mean you’re done with your healthcare for the year.
In fact, there are a handful of other screenings that likely belong on your checklist — or at least your radar. If you’re healthy, the list won’t be long, assures Morton Tavel, M.D., a clinical professor emeritus of medicine at the Indiana University School of Medicine.
Which ones you need depends on your age, sex, medical history, and the latest science. Here are seven recommended screenings to ask your physician about today.
1. Colon cancer screening
The recommended age for getting your first screening for colon cancer used to be 50. Recently, the U.S. Preventive Services Task Force (USPSTF) lowered the age to 45. The reason? Cases of colon cancer among young and middle-aged people are rising, and so are mortality rates. By doing more screenings earlier, experts hope to find more cases in the early stages, when they're easier to treat.
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The gold standard check for colon cancer is a colonoscopy. That’s when a physician inserts a flexible tube with a camera into your rectum and colon while you're sedated. The screening checks for polyps, which are small clumps of tissue that are usually harmless. However, some can develop into cancer, which is why most polyps are removed during the procedure for further testing.
If your first colonoscopy is normal, you need to repeat it only every 10 years, says Dr. Tavel, author of Health Tips, Myths, and Tricks: A Physician’s Advice. If your doctor does find polyps, you might have to have the test done more often.
Some people are also eligible for at-home colon cancer screening. These kits involve collecting a small stool sample and sending it to a lab for review. Ask your physician which approach is right for you.
2. Mammogram
This is a breast X-ray that helps find signs of cancer. The recommendations for mammograms vary depending on your gender identity.
- Cisgender women: The American Cancer Society (ACS) recommends optional annual screening starting at age 40. From 45 to 54, the ACS recommends yearly mammograms. After that, you have the option to switch to every two years. The ACS also states that screenings should continue as long as you're in good health and are expected to live at least 10 more years.
- Transgender women and men: Hormone therapy can raise the risk of breast cancer. The general recommendation is that transgender women and men who have taken hormone therapy for five or more years should have an annual mammogram starting at age 50. These recommendations vary based on factors like age and duration of hormone therapy. They come from the University of California, San Francisco Center of Excellence for Transgender Health.
If you have a family history of breast cancer, your physician may advise earlier screening. But screening more often than recommended could increase the chances of having a false positive — a result that says the disease is there when it’s not. That can lead to anxiety and unnecessary surgery, says Dr. Tavel.
If breast cancer screening is on your checklist, finding an in-network facility is the next step. Sign in to your member portal to find mammogram locations near you.
3. HPV test and Pap test
An HPV test looks for the human papillomavirus, a virus that can cause cervical cancer. A Pap test looks for abnormal cells that can lead to cervical cancer. Sometimes both tests are done together (known as an HPV/Pap co-test).
The ACS recommends that women or people who have a cervix start screening at age 25 and continue until at least 65.
Recommended testing frequency depends on the test:
- HPV test: Every five years
- Pap test: Every three years
- HPV/Pap co-test: Every five years
4. Cholesterol test
Millions of U.S. adults age 20 or older have high cholesterol. But many people don’t know their levels are high because there are no symptoms. The best way to find out? A simple blood test. It looks at four things:
- Total cholesterol. This is the sum of all the cholesterol in your blood.
- Your goal: below 200 mg/dL.
- Low-density lipoprotein (LDL). LDL is the “bad” cholesterol that causes plaque to build up in your arteries, which can lead to a heart attack or stroke.
- Your goal: less than 70 mg/dL if you're at high risk of coronary artery disease. If not, less than 100mg/dL.
- High-density lipoprotein (HDL). This “good” cholesterol helps carry LDL cholesterol away and out of your arteries.
- Your goal: 60 mg/dL or higher.
- Triglycerides. This is a type blood fat stored in your cells. High triglyceride levels are linked with a higher risk of stroke and heart disease.
- Your goal: below 150 mg/dL.
Parents, it's important to get your child's cholesterol checked to help assess their risk. The American Heart Association (AHA) recommends doing this when your child is between ages 9 and 11. Then starting at age 19, the AHA recommends regular screening every five years.
If you’re at a higher risk of heart disease — such as having a family history of heart disease or diabetes, or if you have high cholesterol — talk to your physician about having it checked more often.
5. Blood sugar
This blood test checks your blood sugar levels. Higher-than-normal levels can indicate prediabetes or diabetes. There are two main tests:
- A1C. This measures your average blood sugar level over several months. Here’s what your results mean:
- Below 5.7% = normal
- Between 5.7% and 6.4% = prediabetes
- 6.5% or higher = diabetes
- Fasting blood sugar. This measures your blood sugar after fasting (not eating) overnight. Here’s how to read your results:
- 99 mg/dL or lower = normal
- 100-125 mg/dL = prediabetes
- 126 mg/dL or higher = diabetes
The American Diabetes Association (ADA) recommends that everyone have one of these tests beginning at age 35. If it's normal, you can repeat it every three years.
If you have certain risk factors — including having a higher weight, high blood pressure or cholesterol, or a family history of type 2 diabetes — your physician may recommend screening sooner or more frequently.
6. PSA test
This blood test can help detect early prostate cancer in men or people who have a prostate. It measures a protein made by the prostate gland called prostate-specific antigen (PSA).
The USPSTF recommends that those age 55 to 69 talk with their physician to decide if a PSA test is right for them. It may make sense to get the test if you have certain risk factors, such as being Black or having a strong family history of the disease, says Dr. Tavel.
For others, it may not make sense. The test can result in false positives for people with prostates who have a high level of PSA but don’t have cancer. Or it may show normal results even when someone does have cancer (known as a false negative).
Your doctor may also talk to you about a physical exam for prostate cancer called a digital rectal exam. It’s less effective than a PSA test, according to the ACS, but it can be better at finding prostate cancer in people with normal PSA levels. The USPSTF does not recommend routine screenings for those age 70 and older.
7. CT lung scan
This scan screens your lungs for cancer. Research shows that a yearly CT lung scan can cut the risk of death from cancer by up to 20% in long-term heavy smokers. The USPSTF recommends annual screening for adults age 50 to 80 who have a 20-pack-year smoking history and currently smoke or have quit within the past 15 years.
Your next step: Schedule the screenings that are right for you
Knowing about the key screenings above is the first step in staying well. But for them to work, you also need to schedule the ones you need.
Start by gathering your family medical history. Make a list of any diseases that run in your family (you might have to make a few phone calls). Then share it with your physician to help them create your list of necessary screenings.
If you need help scheduling and keeping track of it all, don’t hesitate to ask. Your physician's support staff is a great place to start. So is your AvMed app, which is included with your plan. It can help you connect with someone on your care team to book appointments or ask questions about your test results without making a single phone call. Plus, you can schedule reminders, so you don’t forget to take care of your future self.
See our sources:
Colorectal cancer screenings: U.S. Preventive Services Task Force and Centers for Disease Control and Prevention
Colorectal cancer screening guidelines: American Cancer Society
Breast cancer screening recommendations: U.S. Preventive Services Task Force
Breast health for the LGBTQ community: Susan G. Komen Breast Cancer Foundation
HPV testing: American Cancer Society
Cervical cancer screening guidelines: The National Cancer Institute
Cholesterol testing: American Heart Association and Mayo Clinic
Diabetes testing: American Diabetes Association and Centers for Disease Control and Prevention
Prostate cancer screening: U.S. Preventive Services Task Force and American Cancer Society
Lung cancer screenings: U.S. Preventive Services Task Force
