Recommended Laboratory Tests for Annual Physical Examinations
For routine annual physical examinations in adults, a comprehensive metabolic panel, complete blood count, lipid profile, and hemoglobin A1C should be included as standard laboratory tests to screen for common conditions and assess overall health status. 1
Core Laboratory Tests
Basic Tests for All Adults
- Complete blood count (CBC) with differential - screens for anemia, infection, and blood disorders 1
- Comprehensive metabolic panel (CMP) - assesses kidney function, liver function, and electrolyte balance 1
- Lipid profile - includes total cholesterol, LDL, HDL, and triglycerides to assess cardiovascular risk 1
- Hemoglobin A1C - screens for diabetes and prediabetes 1
- Urinalysis with albumin-to-creatinine ratio - screens for kidney disease and urinary tract infections 1
Age and Sex-Specific Tests
- Thyroid-stimulating hormone (TSH) - particularly important for women and older adults 1
- Prostate-specific antigen (PSA) - consider annually in men aged 50+ years (earlier in high-risk men) 1
- Hepatitis B screening - recommended for adults with diabetes under age 60 1
Frequency Recommendations
- Most laboratory tests should be performed annually as part of routine physical examination 1
- Lipid profile may be performed less frequently (every 2 years) in people without dyslipidemia and not on cholesterol-lowering therapy 1
- Vitamin B12 levels should be checked annually in patients taking metformin 1
- Serum potassium levels should be monitored in patients taking ACE inhibitors, ARBs, or diuretics 1
Special Considerations
Diabetes Management
- For patients with diabetes, more frequent monitoring is recommended: 1
- A1C test at least twice yearly if meeting treatment goals, quarterly if therapy has changed or not meeting goals
- Annual urine albumin test
- Annual lipid profile (or every 2 years if values are in lower-risk levels)
Cardiovascular Risk Assessment
- More comprehensive lipid testing including apolipoprotein B and lipoprotein(a) may be indicated for patients with family history of premature cardiovascular disease 2
- Blood pressure determination should be performed at every visit 1
Cost-Effective Approach
- Basic metabolic panel (BMP) may be sufficient instead of comprehensive metabolic panel (CMP) in patients without specific risk factors or symptoms suggesting liver disease 3
- Point-of-care testing may improve efficiency in certain clinical settings 4
Common Pitfalls to Avoid
- Ordering unnecessary tests without clinical indication can lead to false positives and unnecessary follow-up testing 3
- Failing to consider patient-specific risk factors when determining which tests to order 1
- Not following up on abnormal results appropriately 5
- Overlooking the need for more frequent monitoring in patients with chronic conditions or on medications that affect laboratory values 1
Remember that laboratory testing should be tailored based on age, sex, risk factors, and current medical conditions. The tests listed above represent a standard approach for most adults during annual physical examinations.