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Health checkups by age: what to check and how often

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Regular health checkups by age help find problems that are not causing symptoms yet. What to check, and how often, depends on your age, sex and personal risk. This guide summarises the milestones recommended by the WHO, the US Preventive Services Task Force (USPSTF), the CDC and the NHS (UK).

Why get checked when you feel fine

The WHO says most people with high blood pressure do not feel any symptoms, and the only way to detect it is to have a health professional measure it. A routine checkup is a chance to take measurements like this, catch up on vaccines and talk about your own risks. See also how to measure blood pressure at home.

Recommendations differ between countries

Each country and organisation has its own schedule. For example, the USPSTF recommends starting cervical cancer screening at 21, while the WHO recommends starting at 30. Treat the milestones below as a reference only. In Vietnam, follow Bộ Y tế (Ministry of Health) guidance and your doctor's advice; your doctor will adjust them to your personal and family history.

Children and teenagers

  • Routine visits: the AAP (American Academy of Pediatrics) suggests several visits in the first 2 years, then one a year from age 3 to 21, to follow growth, development, nutrition and vaccinations.
  • Vaccinations: follow the schedule of Vietnam's Expanded Programme on Immunization (free for children); ask your local health station. The WHO prioritises HPV vaccination for girls aged 9 to 14.
  • Eyes: the USPSTF recommends a vision check at least once between ages 3 and 5.
  • Teeth: the AAP advises a first dental visit after the first tooth appears and by the first birthday. For under-18s, the NHS says check-ups should be no more than 1 year apart.
  • Cholesterol: the CDC advises a test at least once between ages 9 and 11, and again between 17 and 21.
  • Mental health: the USPSTF recommends depression screening for teenagers aged 12 to 18.

Adults 18 to 39

  • Blood pressure: the USPSTF suggests a check every 3 to 5 years if your last reading was normal and you are not at increased risk; every year if you are at increased risk, for example with overweight or obesity.
  • Cholesterol: according to the CDC, most healthy adults should be checked every 4 to 6 years; more often with heart disease, diabetes or a family history of high cholesterol.
  • Hepatitis B and C: the CDC recommends that all adults 18 and older are tested at least once in their lifetime.
  • Cervical cancer: USPSTF: ages 21 to 29, a cytology (Pap) test every 3 years; ages 30 to 65, cytology every 3 years, HPV testing every 5 years, or both together every 5 years. WHO: from age 30, a high-performance test every 5 to 10 years; women living with HIV from age 25, every 3 to 5 years.
  • Mental health: the USPSTF recommends depression screening for all adults, and anxiety screening for adults up to age 64.
  • Eyes: the American Academy of Ophthalmology (AAO) advises adults under 40 with healthy eyes to have a complete eye exam every 5 to 10 years.
  • Teeth: the NHS says check-ups can be anywhere from 3 months to 2 years apart, as your dentist recommends.
  • Vaccinations: the CDC recommends a flu vaccine every season for everyone 6 months and older.

Adults 40 to 64

Keep up the checks above, and add:

  • Blood pressure: every year from age 40 (USPSTF).
  • Weight and blood sugar: the USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 with overweight (BMI 25 or more) or obesity; if results are normal, every 3 years may be reasonable. For Asian Americans, the USPSTF suggests considering screening from a BMI of 23.
  • Colorectal cancer: screening from 45 to 75 (USPSTF).
  • Breast cancer: a mammogram every 2 years for women aged 40 to 74 (USPSTF).
  • Lung cancer: a yearly low-dose CT scan for adults aged 50 to 80 with a smoking history of at least 20 pack-years who still smoke or quit within the past 15 years (USPSTF).

Age 65 and older

  • Bones: the USPSTF recommends bone density testing for women 65 and older; younger postmenopausal women should be tested if a risk assessment shows a higher fracture risk. For men, the evidence is not enough to make a recommendation.
  • Eyes: an eye exam every 1 to 2 years (AAO).
  • Hearing: the WHO lists older adults among the groups who need hearing screening.
  • Colorectal cancer: from 76 to 85, your doctor decides case by case (USPSTF).
  • Cervical cancer: the USPSTF does not recommend screening after 65 if earlier screening was adequate and you are not at high risk.
  • Depression and vaccines: depression screening still applies (USPSTF), and so does a flu vaccine every season (CDC).

Preparing for your checkup

  1. List every medicine you take, including over-the-counter medicines, vitamins, supplements and herbal products.
  2. Note your symptoms: when they started and how long they have lasted.
  3. Note past illnesses, operations, allergies, and illnesses in your parents and siblings.
  4. Only fast if you are told to. The CDC says a cholesterol test may need 8 to 12 hours of fasting; your doctor will tell you how to prepare.
  5. Write your questions down: Which screening tests and vaccines do I need? What are the benefits and risks of this test? When should I come back?

Keep your results in one place

Keep test results, prescriptions and your vaccination record by date, in a paper file or a folder on your phone. Bring them to every visit, especially when you change clinics.

Do not wait for a checkup if you have danger signs

A routine checkup does not replace seeing a doctor for new symptoms. Call 115 straight away if you notice (NHS):

  • Chest pain that feels crushing or squeezing, which may spread to the arm, neck or jaw.
  • Severe difficulty breathing: gasping, choking or not able to get words out.
  • Pale, blue or grey lips or skin.
  • One side of the face drooping, weakness in one arm, or slurred or confused speech.
  • Sudden blurred vision or loss of sight in one or both eyes.
  • Someone who has passed out and is not responding normally.

The NHS notes that stroke symptoms can stop after a short time, but you still need emergency help straight away.

Clinics can share this article with their patients.

Sources

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