Recommended Wellness Screenings for Adults by Age
Adults should undergo age-specific wellness screenings that prioritize cardiovascular disease prevention, cancer detection, and metabolic disorders, with screening intensity and selection guided by life expectancy and individual risk factors rather than age alone.
Ages 18-39 Years
Cardiovascular Screening
- Blood pressure measurement at every clinical encounter 1
- Hypertension screening annually for high-risk patients or every 3-5 years for low-risk adults with no risk factors 2
- Confirm hypertension diagnosis outside the clinical setting before initiating treatment 2
Metabolic Screening
- Screen adults aged 35-39 years who have overweight or obesity for prediabetes and type 2 diabetes using fasting plasma glucose, hemoglobin A1C, or oral glucose tolerance test 2
- Repeat screening every 3 years if normal; consider annual screening for high-risk patients 2
Infectious Disease Screening
- Screen sexually active females under age 25 years for chlamydia 2
- Screen at-risk males per CDC STD Treatment Guidelines 2
- Screen persons with HIV infection at least annually for hepatitis C 2
Ages 40-49 Years
Cardiovascular Screening
- Blood pressure measurement at every clinical encounter 1
- Annual lipid profile screening for men aged 40-49 years 1
- Annual blood pressure measurement and lipid profile screening for men to assess cardiovascular risk 1
Metabolic Screening
- Screen all adults aged 40-49 years who are overweight or obese for prediabetes and type 2 diabetes 2
- Refer those with abnormal glucose to intensive behavioral counseling 2
Cancer Screening
- Begin colorectal cancer screening at age 45 years with annual fecal immunochemical test (FIT), colonoscopy every 10 years, or CT colonography every 5 years 3, 1
- Women aged 40-44 years should have the opportunity to begin annual mammography screening 3
- Women aged 45-54 years should undergo annual mammography screening 3
Cervical Cancer Screening
- Women aged 40-49 years should continue screening every 5 years with both HPV test and Pap test (preferred) or every 3 years with Pap test alone 3
Lung Cancer Screening
Prostate Cancer Screening
- Do not order PSA testing at age 48 for average-risk men, as harms of PSA-based screening and overtreatment outweigh potential benefits 1
- Exception: African American men or those with strong family history should have screening discussion at age 45 years 1
Ages 50-64 Years
Cardiovascular Screening
Metabolic Screening
- Screen all adults aged 50-64 years who are overweight or obese for prediabetes and type 2 diabetes 2
Cancer Screening
- Colorectal cancer screening is a strong recommendation for adults aged 50-75 years with colonoscopy every 10 years or annual FIT as first-tier options 3
- Alternative options include CT colonography every 5 years, flexible sigmoidoscopy every 5-10 years, or multitarget stool DNA test every 3 years 3
- Women aged 55-64 years should transition to biennial mammography or continue annual screening 3
- Women should continue mammography as long as overall health is good and life expectancy exceeds 10 years 3
Cervical Cancer Screening
- Women aged 50-64 years continue screening every 5 years with both HPV test and Pap test (preferred) or every 3 years with Pap test alone 3
Lung Cancer Screening
- Annual low-dose helical CT for adults aged 55-64 years who currently smoke or quit within the past 15 years AND have at least a 30-pack-year smoking history 3, 4
- Screening requires evidence-based smoking cessation counseling for current smokers and informed/shared decision-making process 3
Prostate Cancer Screening
- Men aged 50-64 years with at least 10-year life expectancy should have opportunity for informed decision-making about PSA testing after receiving information about potential benefits, risks, and uncertainties 3
Abdominal Aortic Aneurysm Screening
Ages 65-75 Years
Cardiovascular Screening
- Blood pressure measurement at every clinical encounter 1
- Continue lipid screening based on cardiovascular risk 4
Metabolic Screening
- Screen adults aged 65-70 years who have overweight or obesity for prediabetes and type 2 diabetes 2
Cancer Screening
- Continue colorectal cancer screening through age 75 years in adults in good health with life expectancy greater than 10 years 3
- Colonoscopy every 10 years or annual FIT remain first-tier options 3
- Women continue biennial mammography as long as overall health is good and life expectancy exceeds 10 years 3
Cervical Cancer Screening
- Women aged 65 years who have had ≥3 consecutive negative Pap tests or ≥2 consecutive negative HPV and Pap tests within the last 10 years (with most recent test in last 5 years) should stop cervical cancer screening 3
Lung Cancer Screening
- Continue annual low-dose CT through age 75 years for those who currently smoke or quit within past 15 years with at least 30-pack-year history 3, 4
Abdominal Aortic Aneurysm Screening
Comprehensive Geriatric Assessment
- All individuals aged 65 and older should undergo systematic geriatric evaluation including physical and cognitive function, emotional health, comorbidities, polypharmacy, nutrition, and social support 6
Ages 76-85 Years
Cancer Screening
- Individualize colorectal cancer screening decisions based on patient preferences, life expectancy, health status, and prior screening history 3
- Healthy 76-year-olds who have never been screened may benefit from screening, while those with regular normal screening tests may reasonably discontinue 3
- Discourage routine screening on a population basis, as modeling suggests benefits may not exceed harms after age 75 years in persons with screening history 3
- Women continue mammography only if overall health is good and life expectancy exceeds 10 years 3
Lung Cancer Screening
- Continue annual low-dose CT through age 80 years for those who currently smoke or quit within past 15 years with at least 30-pack-year history 3, 4
Comprehensive Geriatric Assessment
- Systematic screening for malnutrition using Mini Nutritional Assessment-Short Form (MNA-SF) every 3-6 months 6
- Cognitive evaluation using Mini-Mental State Examination when impairment is suspected 6
- Systematic medication review to identify polypharmacy and potentially inappropriate medications 6
- Fall risk screening with single question: "Have you fallen in the past year?" 6
- Depression screening using Patient Health Questionnaire-2 (PHQ-2) 6
- Evaluation of activities of daily living and instrumental activities of daily living 6
Ages 85+ Years
Cancer Screening
- Discourage colorectal cancer screening in adults over age 85 years 3
- Exception: patients who have never been screened and are in excellent health with life expectancy greater than 10 years may be considered 6
- Systematic colorectal cancer screening is generally not recommended at age 85 years 6
Comprehensive Geriatric Assessment
- Continue systematic geriatric evaluation every 3-6 months including malnutrition screening, cognitive function, medication review, fall risk, emotional state, and functional autonomy 6
- Liberalize dietary restrictions (low-sodium, low-cholesterol diets) to reduce risk of malnutrition and functional decline 6
Critical Pitfalls to Avoid
- Do not order routine CBC or comprehensive metabolic panels without specific clinical indications, as this leads to false positives and unnecessary follow-up 1
- Do not skip colorectal cancer screening starting at age 45 years, as this is critical for mortality reduction 1
- Do not perform PSA testing in average-risk men under age 50 years, as it provides no benefit and leads to unnecessary anxiety, biopsies, and overtreatment 1
- Do not continue cancer screening in patients with life expectancy less than 10 years, as survival benefit is not seen 5
- Do not screen for breast or prostate cancer without informed decision-making and consideration of life expectancy 7