What are the recommended prevention screenings from birth to 100 years old?

Recommended Prevention Screenings from Birth to 100 Years Old

The most effective preventive screening strategy should be age-appropriate, evidence-based, and follow established guidelines from major health organizations to reduce morbidity and mortality across the lifespan.

Newborn and Childhood Screenings

• Newborn screening: Universal metabolic, hearing, and congenital heart disease screening
• Vision and hearing: Regular screening throughout childhood during well-child visits
• Growth and development: Height, weight, head circumference, developmental milestones
• Blood pressure: Annual screening beginning at age 3
• Immunizations: Following CDC recommended schedule

Adolescent Screenings (12-18 years)

• Depression screening: Annual screening beginning at age 12
• Substance use assessment: Annual screening
• Sexual health counseling and STI screening: Based on risk factors
• Blood pressure: Annual screening
• Lipid screening: Once between ages 9-11 and again between 17-21

Adult Screenings (18-39 years)

• Blood pressure: Annual screening 1
• Lipid panel: Every 5 years with normal results 1
• Depression screening: Annual screening
• STI screening: Based on risk factors
• HIV screening: At least once for all adults 18-65
• Cervical cancer (women): Pap test every 3 years starting at age 21

Middle-Age Screenings (40-64 years)

• Colorectal cancer: Begin at age 45 with options including:

  • Annual FIT
  • Annual high-sensitivity gFOBT
  • Multi-target stool DNA test every 3 years
  • Colonoscopy every 10 years
  • CT colonography every 5 years
  • Flexible sigmoidoscopy every 5 years 2, 1

• Breast cancer (women):

  • Ages 40-44: Option to begin annual mammography (qualified recommendation)
  • Ages 45-54: Annual mammography (strong recommendation)
  • Ages 55+: Biennial mammography or continue annual screening based on preference 2

• Prostate cancer (men):

  • Ages 55-69: Shared decision-making approach to discuss PSA screening benefits and harms 1

• Diabetes: Screening every 3 years for adults aged 40-70 years with BMI ≥25 1

• Lung cancer: Annual low-dose CT for adults 50-80 years with 20 pack-year smoking history who currently smoke or quit within past 15 years

Older Adult Screenings (65+ years)

• Colorectal cancer: Continue screening through age 75; individualize decisions for ages 76-85 based on health status and prior screening history; not recommended after age 85 2

• Breast cancer (women): Continue screening as long as overall health is good and life expectancy is 10+ years 2

• Prostate cancer (men): Not routinely recommended after age 70 1

• Abdominal aortic aneurysm: One-time screening for men aged 65-75 who have ever smoked 2

• Bone density:

  • Women: Begin at age 65
  • Men: Begin at age 70 1
  • Earlier for both sexes with risk factors

• Cognitive assessment: Annual evaluation for cognitive impairment

HIV-Specific Screening Recommendations

For HIV-positive individuals, additional screenings are recommended 2:

• More frequent lipid and glucose monitoring (every 6-12 months)
• Annual STI screening (or more frequent based on risk)
• Annual tuberculin screening if at risk
• More frequent cervical cancer screening for women

Common Pitfalls in Preventive Screening

1. Overscreening: Performing tests more frequently than recommended can lead to false positives, unnecessary procedures, and patient anxiety.

2. Underscreening: Failing to screen high-risk populations appropriately can miss opportunities for early intervention.

3. Neglecting shared decision-making: Particularly important for prostate cancer screening where benefits and harms must be carefully weighed 1.

4. Failing to consider life expectancy: Screening should be discontinued when potential harms outweigh benefits, typically when life expectancy is less than 10 years.

5. Not adapting to risk factors: Certain populations may need earlier or more frequent screening based on family history, race, or other risk factors.

Special Considerations

• Race/ethnicity: Some guidelines recommend earlier colorectal cancer screening for African Americans (age 45) 2.

• Family history: May warrant earlier screening for breast, colorectal, and prostate cancers.

• Transgender individuals: Evidence suggests lower rates of preventive screening utilization among transgender adults compared to cisgender counterparts 3, requiring special attention to ensure appropriate organ-based screening regardless of gender identity.

• Risk-based screening: For breast cancer, women in their 40s with risk factors that increase their risk by 2.46 times or more should consider mammography as their absolute risk equals that of an average 50-year-old woman 2.

The implementation of these evidence-based screening recommendations can significantly reduce morbidity and mortality while improving quality of life across the lifespan.