Why screen at all
A screening is a test given to someone with no symptoms, aimed at conditions that are silent for years and far easier to treat early. High blood pressure is the standard example. It causes no sensation until it has damaged the heart, kidneys or eyes. The schedules below follow the US Preventive Services Task Force and the major medical societies as they stand now, and they are revised from time to time, so confirm them with your doctor.
In your twenties
- Have your blood pressure measured at least every three to five years, and yearly if your readings run above normal.
- Get a baseline cholesterol panel, which the American Heart Association suggests repeating every four to six years when it is normal.
- If you have a cervix, begin Pap tests at 21 and repeat them every three years.
- Be tested once for hepatitis C and at least once for HIV, as every adult is advised to be.
- Expect a short depression questionnaire at checkups, and answer it truthfully.
In your thirties
Keep all of the above going. From 30, cervical screening may shift to an HPV test every five years or continue as a Pap test every three, according to your doctor's advice. Blood sugar testing for diabetes is advised from 35 for people who are overweight, and earlier for those with a strong family history. Look over your own skin every few months. A mole that is asymmetric, ragged at the border, uneven in color, wider than a pencil eraser or changing should be seen by a dermatologist.
What comes next, and what moves it earlier
Colorectal cancer screening now begins at 45 for people at average risk, and mammograms are advised every two years from 40. Family history changes those dates. A parent or sibling with colon cancer usually means starting at 40, or ten years before the age at which the relative was diagnosed, whichever comes first. Early heart disease or breast or ovarian cancer in close relatives likewise changes what gets ordered.
What it costs
Most health plans must cover screenings recommended by the task force with no copay when you use an in-network provider. The catch lies in billing codes. A test ordered because of a symptom is diagnostic, not preventive, and your deductible may apply. Ask which it is before the blood is drawn.
Note More testing is not better testing. Whole-body scans and broad panels sold directly to healthy young adults produce false alarms and follow-up procedures far more often than they find real disease.
