Tune up your body: A health checklist for every age

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Here’s a healthy new habit to start in 2024: Make January the month you schedule all your preventive care appointments for the year.

As a physician, I often hear from patients who tell me they had no idea that they were due for a screening test. By making January your medical planning month, you’ll mark appointment dates on the calendar right now so you don’t have to worry about it later.

I’ve created an easy checklist, based on recommendations from the U.S. Preventive Services Task Force (USPSTF) and other organizations, to help you identify the screenings and checkups everyone needs.

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All ages

These are the health screenings, checkups and vaccinations that everybody needs, from your 20s to midlife to older age. Screening guidelines can vary depending on your personal health history, so remember to talk to your provider about your individual needs.

Blood pressure: Get your blood pressure checked every three to five years. (Anything above 120/80 mm Hg is considered abnormal.) The USPSTF recommends that those at higher risk, including all African Americans, get tested at least every year.

Cholesterol: Catching high cholesterol early gives you a chance to lower your risk of heart disease. Most otherwise healthy adults should aim for an LDL, or low-density lipoprotein, of less than 100 mg/dL. Men should start regular screening for hyperlipidemia at the age of 35. Women should start at age 45. (Anyone with risk factors such as smoking or family history may be advised to screen sooner.) Depending on the results, repeat screening every three to five years.

Type 2 diabetes: Get screened every three years for Type 2 diabetes starting at age 35 with a simple blood test called a hemoglobin A1C. If you’re overweight or have a family history of diabetes, hypertension or high cholesterol, your doctor may test more frequently.

Depression: Depression can sometimes manifest in subtle ways like difficulty concentrating. If you have any concerns, talk to your provider to get more help.

Hepatitis B and C: The CDC recommends screening those 18 or older for hepatitis B and C at least once in their lifetimes. The prevalence of chronic hepatitis C has shifted affects multiple generations, including millennials, Gen Xers and baby boomers.

HIV: Get screened for HIV at least once in your lifetime, or more often if you’re at higher risk. Men who have sex with men are the most commonly affected by HIV, but about 1 in 5 new cases are among those reporting heterosexual contact, and the majority of these were women.

Cancer screening

Skin cancer: The USPSTF doesn’t recommend skin screenings, but you should talk to your primary care physician about any suspicious lesions, including those that are new or change in color, shape and size.

Annual or booster vaccinations

Flu: Getting the annual vaccine can lower your risk of illness and prevent you from spreading it to older friends and relatives. Flu shots become even more important as you get older.

Covid-19: Make sure you’re up to date with boosters that cover the latest strains. The vaccine also can reduce the risk of long covid, which affects about 1 in 5 Americans who have ever had the virus.

Tdap (tetanus, diphtheria, and whooping cough): You probably were vaccinated for Tdap as a baby and then received a booster later in childhood. All adults age 18 and older should get a booster every 10 years. Check with your primary care provider when your last shot was and make sure you’re all caught up.

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Ages 20 to 39

Many young people take health for granted, but these are key years to discuss your family history, risk factors and screening plans with your provider.

Body checkups

Find a doctor: If you don’t have a primary care provider, now is the time to get one. Visit them at least once every three years. Your doctor will check blood pressure, cholesterol and risk for Type 2 diabetes, among other things, and discuss any concerns you have.

Eye exams: The American Academy of Ophthalmology recommends a complete eye exam once in your 20s and twice in your 30s. A complete eye exam typically involves dilating the pupil to get a closer look at the retina and optic nerve. Routine vision checks for glasses or contacts don’t count.

Dental exams: The American Dental Association recommends dental cleanings about every six months as well as periodic X-rays.

Cancer screening

Cervical cancer: Most women don’t need annual Pap tests. Get one every three years between the ages of 21 to 29, or more frequently for the immunocompromised. Starting at age 30, you may have the option of co-testing – Pap and human papillomavirus (HPV) – every five years.

Breast cancer: Patients in their 20s and 30s typically aren’t screened for breast cancer, but this is a good time to discuss your risk with your provider. Patients at high risk, such as those with a strong family history, may be advised to start mammograms as early as age 25.

Sexual health

STDs: Women should get screened for STDs such as chlamydia and gonorrhea regularly starting when they’re sexually active until age 25. Younger women have a higher risk of STDs than older women, due in part to differences in their immune system and changes to the cervix that occur with age. Otherwise, both men and women should screen if they have a new sexual partner or as advised by their doctor. (Men who have sex with men should get tested at least annually.)

Additional vaccinations

HPV: Before the age of 26, both men and women should complete the vaccine series. It’s a misconception that HPV vaccination is only for women to prevent cervical cancer. HPV can cause genital warts. In men, it can also lead to penile, anal or oropharyngeal cancers.

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Ages 40 to 49

Cancer screenings become more important in your 40s, when most people start getting colonoscopies and mammograms. Visit your primary care provider at least every three years.

Body checkups

Routine screenings: Keep getting your blood pressure, cholesterol and A1C checked every three to five years.

Eye exams: Get a complete eye exam at age 40, when the American Academy of Ophthalmology recommends screening for glaucoma or diabetic retinopathy. Talk to your doctor about the timing of your next exam. A complete eye exam typically involves dilating the pupil to get a closer look at the retina and optic nerve.

Dental exams: The American Dental Association recommends dental cleanings about every six months as well as periodic X-rays.

Cancer screening

Colorectal cancer: Get your first colonoscopy at age 45, or sooner if you have a high-risk history like inflammatory bowel disease or a first-degree relative with early-onset colorectal cancer. Some groups, such as the American College of Physicians, advise African Americans to start screening at age 40.

Cervical cancer: Most women don’t need annual Pap tests. Get a Pap test every three years or a co-test – Pap and human papillomavirus (HPV) – every five years.

Breast cancer: Women of average risk should start screening mammograms at age 40 and repeat it every one or two years.

Prostate cancer: The USPSTF does not officially recommend a widespread screening program. But the American Cancer Society says Black men, who are at higher risk, should start a conversation with their provider about a screening PSA blood test at age 45.

Sexual health

STD tests: Get periodic STD checks if you’re sexually active with new partners, are otherwise at higher risk or have any concerns. Men who have sex with men should get tested at least annually.

Additional vaccinations

Except for the vaccines listed for every age above, no additional vaccines are routinely recommended during your 40s.

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Ages 50 to 59

The risks of getting cancer or heart disease increase at around age 50, so it’s more important than ever to make screening appointments. Most people in their 50s have at least one chronic medical condition, so start seeing your primary care provider at least once a year.

Body checkups

Routine screenings: Keep getting your blood pressure, cholesterol and A1C checked every three to five years. As you age, your doctor may suggest these tests annually depending on your overall health.

Eye exams: For healthy people, the American Academy of Ophthalmology recommends complete eye exams every two to four years between ages 40-54 and then every one to three years between ages 55-64.

Dental exams: The American Dental Association recommends dental cleanings about every six months as well as periodic X-rays. Oral cancer risk increases with age, so discuss any changes in your mouth with your dentist.

Cancer screenings

Lung cancer: If you are or have been a heavy smoker, you may be eligible for lung cancer screening with a yearly low-dose chest CT scan. If you’re a candidate, these should be done every year starting at age 50.

Prostate cancer: At age 50, men should discuss the pros and cons of a PSA screening blood test with their provider if they haven’t already.

Cervical cancer: Most women don’t need annual Pap tests. Get a Pap test every three years or a co-test – Pap and human papillomavirus (HPV) – every five years.

Breast cancer: The USPSTF recommends a screening mammogram every two years for women of average risk. According to the American Cancer Society, women should get mammograms yearly from age 45-54 and every other year after 55.

Colorectal cancer: You should have had your first screening colonoscopy at age 45. If the results were normal, a follow-up is recommended between 52 and 55 – about seven to 10 years after the first.

Sexual health

STDs: Continue to get periodic STD checks if you’re sexually active with new partners or have other concerns. Men who have sex with men should get tested at least annually.

Additional vaccinations

Shingles: Shingles is a painful condition caused by the same varicella-zoster virus that causes chickenpox. The vaccine is recommended for everyone 50 or older even if they don’t remember having had chickenpox in the past.

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Ages 60 and older

In your 60s, 70s, 80s and beyond, you’ve made it to a vibrant and ever-growing population of older Americans. This is a great time to focus on exercises that can reduce your risk of falling, such as resistance training or tai chi. As you enter your 70s, many routine screenings may end, but that doesn’t mean you shouldn’t still be vigilant about your health. This is a time in life where it makes sense to meet with your primary care provider at least once a year to check in.

Body checkups

Routine screenings: Keep getting your blood pressure, cholesterol and A1C checked. As you age, your doctor may suggest doing these tests more frequently. The USPSTF does not recommend continuing to screen for diabetes after the age of 70. There’s no clear cutoff for stopping cholesterol screening, but you and your physician may decide to stop checking as you approach your 70s.

Hearing loss: Some groups advocate for hearing loss screening at age 60 or older regardless of symptoms, though the USPSTF doesn’t advise it. If you have any concerns about your hearing, talk to your physician about testing.

Osteoporosis: Starting at age 65, women should get a scan that evaluates bone mineral density. Osteoporosis is more common in women, who lose up to 20 percent of their bone mineral density after menopause. Breaking your hip at this age is a very serious concern – at least a fifth of people who suffer a hip fracture die within a year due to complications. The USPSTF does not recommend routine screening for men, but men at higher risk – such as those with steroid use or prior fractures – should discuss testing with their physicians.

Abdominal aortic aneurysm: Men who have ever smoked should get a one-time screening for abdominal aortic aneurysm with a simple ultrasound between the ages of 65 to 75. This guideline is based on several studies, most of which involved people who had smoked 100 or more cigarettes in their lifetime.

Memory tests: If you or a caregiver has concerns about your memory, ask your physician about cognitive screening.

Medication reviews: Schedule regular medication reviews with your primary care physician. Many older adults are prescribed multiple medications that can cause cognitive problems or other side effects when taken together.

Dental care: Continue twice-yearly visits to your dentist. Medicare doesn’t cover most dental care, so you may want to look into a private plan. Risk of oral cancer increases with age, so discuss any changes in your mouth with your dentist. Dry mouth is another common condition of aging, often associated with multiple medications. It can lead to tooth decay and infection, so discuss the symptom with your doctor.

Eye exams: By age 65, you should be getting your eyes checked every year or two. Regular eye exams are even more important after 60 as many age-related conditions, such as diabetes or hypertension, can affect eye health. Vision disorders associated with aging include age-related macular degeneration, cataracts, diabetic retinopathy, dry eye, glaucoma and retinal detachment.

Cancer screenings

Colorectal cancer: In your 60s and early 70s, people at average risk should be getting a screening colonoscopy every seven to 10 years. You’ll need them more frequently if you have had large or multiple polyps on prior colonoscopies. After the age of 75, you may no longer need to continue screening, but it’s an individual decision based on your own health risks.

Cervical cancer: Most women don’t need annual Pap tests. Get a Pap test every three years or a co-test – Pap and human papillomavirus (HPV) – every five years. Women should continue Pap testing until age 65 when they can stop if they’ve had three recent consecutive negative Pap tests. Otherwise, keep on testing.

Breast cancer: Continue getting screening mammograms every one to two years. If you’re in good health, you and your physician may decide to continue screening into your old age, although the USPSTF recommends stopping at 75.

Prostate cancer screening: Prostate cancer screening is not typically recommended for men 70 and older. Slow-growing prostate cancers are common in older men, and finding them isn’t likely to help you live longer.

Sexual health

STDs: Age doesn’t protect you from STDs. Continue to get periodic checks if you’re sexually active with new partners or have other concerns. Sexually transmitted infections among adults age 65 and older more than doubled from 2007 to 2017. It’s advisable to use protection during sex with new partners to reduce (although it will not eliminate) the risk of STDs.

Additional vaccinations

Flu: You should be getting a flu vaccine annually, but it’s especially important once you hit your 60s. More than 90 percent of deaths due to influenza occur among individuals aged 65 years and older.

Pneumococcal: At the age of 65, it’s recommended you get a pneumococcal vaccine, which can protect you from pneumonia.

RSV (respiratory syncytial virus): A one-time RSV vaccine may be recommended for adults age 60 and older who have underlying health conditions, like chronic obstructive pulmonary disease and diabetes, that put them at higher risk of complications. It’s also worth considering if you spend a lot of time with younger children, who like older adults, are more vulnerable to RSV.

Covid: Make sure you’re up to date on coronavirus vaccines and boosters. Talk to your doctor about taking Paxlovid if you contract covid-19.

Shingles: Get your shingles vaccine if you didn’t already. Shingles is a painful condition caused by the same varicella-zoster virus that causes chickenpox. The vaccine is recommended for everyone 50 or older even if they don’t remember having had chickenpox in the past.