What baseline laboratory tests should a generally healthy adult female have performed annually?

Annual Laboratory Testing for Generally Healthy Adult Females

For generally healthy adult females, there are no universally recommended annual laboratory tests based on age alone—screening should be risk-based and targeted to specific conditions rather than routine yearly labs. 1

Age-Based Screening Thresholds

Diabetes Screening

• Begin at age 35 years for all patients, regardless of other risk factors 1
• If results are normal, repeat testing at minimum 3-year intervals (not annually) 1
• Test more frequently (potentially annually) only if:
  • BMI ≥25 kg/m² (≥23 kg/m² in Asian Americans) with additional risk factors (first-degree relative with diabetes, hypertension ≥140/90 mmHg, HDL <35 mg/dL, triglycerides >250 mg/dL, PCOS, physical inactivity, history of gestational diabetes) 1
  • Prediabetes already documented (A1C ≥5.7%, impaired fasting glucose, or impaired glucose tolerance)—these patients require yearly testing 1

Lipid Screening

• No specific annual lipid panel recommendation exists in the general healthy female population from the guidelines provided 1
• For HIV-infected patients, fasting lipid profiles are recommended every 6-12 months, but this does not apply to the general population 1

Blood Pressure

• Annual blood pressure checks are recommended for all patients 1

Cancer Screening (Not Laboratory Tests)

The following are not laboratory tests but are important age-based screenings:

Cervical Cancer Screening

• Ages 21-29: Pap test every 3 years 1, 2
• Ages 30-65: Either HPV + Pap cotest every 5 years (preferred) OR Pap test alone every 3 years 1, 2
• Age >65: Discontinue if adequate prior negative screening documented (3 consecutive negative Paps OR 2 consecutive negative HPV/Pap cotests in past 10 years, most recent within 5 years) AND no history of high-grade lesions 1, 3, 2

Breast Cancer Screening

• Ages 40-44: Optional to begin annual mammography 1
• Ages 45-54: Annual mammography 1, 2
• Age ≥55: Transition to biennial (every 2 years) or continue annually based on preference 1, 2

Colorectal Cancer Screening

• Begin at age 45 with various options (annual FIT, colonoscopy every 10 years, etc.) 1

Key Clinical Distinctions

What NOT to Order Annually

The evidence does not support routine annual comprehensive metabolic panels, complete blood counts, thyroid function tests, or lipid panels in asymptomatic healthy women without specific risk factors 1. The shift in modern guidelines emphasizes risk-stratified rather than age-based or calendar-based laboratory screening.

Common Pitfalls to Avoid

• Ordering annual "routine labs" without clinical indication—this represents low-value care and can lead to false positives, unnecessary follow-up testing, and patient anxiety 1
• Failing to screen for diabetes starting at age 35—this is now recommended for all adults regardless of risk factors, though repeat interval is 3 years, not annually 1
• Continuing Pap smears after age 65 in adequately screened women—this provides no benefit and represents overscreening 3, 2
• Assuming "yearly physical" requires yearly laboratory work—health maintenance visits focus on counseling, risk assessment, and appropriate interval screening, not reflexive annual labs 4

Special Populations Requiring More Frequent Testing

• Prediabetes or diabetes: Annual glucose/A1C monitoring 1
• Known cardiovascular risk factors: More frequent lipid and glucose monitoring based on specific conditions 1
• History of gestational diabetes: Lifelong testing at least every 3 years 1
• Immunocompromised states (HIV, transplant, chronic immunosuppression): More intensive monitoring per disease-specific guidelines 1, 3