Your Screening Roadmap
Screenings are the closest thing medicine has to a cheat code.
And almost nobody is on schedule with them, usually because no one ever said here's what you need this decade and here's what you can skip. So find your decade below. You'll be done in five minutes.
Two notes first: these are for average risk, and family history usually moves start dates earlier, so if a parent or sibling had something serious young, have that conversation regardless of your decade. And screening means looking before symptoms. If you already have a symptom, you don't need a schedule, you need an appointment.
Every decade
No matter which one you're in.
Blood pressure Yearly at minimum
Free at most pharmacies, more often if yours has ever run high. No symptoms for years, which is exactly why it does so much damage.
Cholesterol & blood sugar Yearly is a fine default
Guidelines allow longer gaps if your numbers have always been clean, but a yearly draw is cheap, easy, and builds the trend, and the trend is the point.
Dental & eye exams Dental twice a year, eyes every 1–2 years
Dentists find oral cancers, eye exams catch diabetes and blood pressure damage early. Health care, not grooming.
Skin awareness Self-check monthly, formal check yearly if higher risk
New, changing, bleeding, or different from all your others: show someone. Fair skin, childhood burns, or family melanoma history is what moves you into the yearly-dermatologist group.
Hepatitis C & HIV Once, more with ongoing risk
Both now very treatable, which is exactly why finding them matters.
Your 20s
The lightest decade, which is why building the habit now is the whole game.
Cervical cancer screening Starts at 21, every 3 years
A genuine success story: it catches changes years before they become cancer. Three years is the real guideline, and an abnormal result puts you on a closer schedule automatically.
STI screening Yearly, more with new partners
Chlamydia and gonorrhea are common and usually silent, which is why at least annual screening is specifically recommended for sexually active women under 25.
Baselines Start the yearly habit now
A cholesterol panel and blood sugar every year means future-you always has something to compare against. A number means more when you know what yours used to be.
My take: the most valuable thing you can do in your 20s is boring: find a primary care doctor before you need one. Getting established while you're sick is a special kind of misery, and I watched people use the ER as a substitute for a decade.
Your 30s
Cervical screening HPV testing, every 5 years
Less frequent and more accurate than the old way, and that interval is the actual guideline. Fewer appointments, better data. Take the win.
Blood sugar Every 1–3 years from 35
Yearly if you're carrying risk factors or your A1c is creeping. This is the decade prediabetes shows up quietly, and the decade it's easiest to reverse.
Thyroid & ferritin With symptoms, and worth a baseline
Both affect energy and cycles, both get missed, both are reasonable asks.
My take: your 30s are when "just tired because life" starts hiding real findings. Tired is worth one proper workup: CBC, ferritin, TSH, vitamin D, A1c. If it all comes back clean, now you know it's your schedule. That's useful too.
Your 40s
The decade the calendar gets real. Starting on time is most of the benefit.
Mammogram Yearly from 40 for many
National guidance says at least every two years, and several major groups recommend yearly. Have the frequency conversation with your doctor, but the start date is 40 and yearly is a completely reasonable ask.
Colon cancer screening Starts at 45
Colonoscopy every ten years is the standard, and the home FIT stool test is yearly, which makes it both the gentler option and the more frequent one. The best test is the one you'll actually do. The age moved from 50 because colon cancer under 50 is rising.
ApoB & Lp(a) ApoB with each panel, Lp(a) once
The higher-resolution heart picture. Both explained in Lab Values Decoded.
Perimenopause literacy This decade
It can start in your early 40s and gets misdiagnosed as anxiety or "stress" constantly. Symptoms are data. Track them.
My take: if you do exactly two things from this whole guide, make them the mammogram at 40 and the colon screening at 45. Book them in your birthday month so you never have to remember.
Your 50s
Everything from your 40s continues, on schedule.
Lung cancer screening Yearly, 50–80 with heavy smoking history
An annual low-dose CT, recommended and covered, and almost nobody knows it exists. Current smokers or quit within 15 years. If this is you or someone you love, this is the most important line on the page.
Shingles vaccine At 50, two doses, once
Ask anyone who's had shingles whether they'd go back and get the shot.
Bone density awareness Risk factors move it earlier
The decade after menopause is when bone loss moves fastest. Early menopause, family hip fractures, long-term steroids, small frame, or smoking history all move the first DEXA up from the standard 65, so ask rather than wait.
My take: the 50s are when the screenings you did or didn't do start paying out, in both directions. It's also never too late. A first colonoscopy at 56 is infinitely better than none.
Your 60s and beyond
Bone density (DEXA) At 65, earlier with risk, repeat per results
Hip fractures change lives, and bone loss is silent right up until they happen. Your first scan sets the repeat schedule. Men with risk factors aren't exempt either.
Abdominal aortic aneurysm ultrasound Once, men 65–75 who smoked
One painless ultrasound, one time. Almost nobody's heard of it.
Colon screening Continues to 75
Then becomes an individual conversation.
Vaccines Flu & COVID yearly, pneumonia & shingles per schedule
Immune systems age, and these do heavy lifting.
Hearing & vision Yearly now
Untreated hearing loss is linked to isolation and cognitive decline, and people wait years too long because it creeps.
My take: the goal of this decade's list isn't more years, it's keeping the years fully usable. Bones that don't break, ears that keep you in the conversation, a heart that lets you travel.
The standing rule: I'm a nurse giving you education, not your nurse giving you medical advice. Your history changes these timelines, so bring the list to someone who knows it.