The health tests you need at 30, 40 and 50

Earlier this month, a government-backed expert group lowered the age at which it recommends women start having mammograms to 40, from 50 previously. cancer screenings at age 45, even though that same expert panel lowered its recommendation from age 50 two years ago.

Most of the general recommendations are for healthy people at average risk. If you are at higher risk of developing a disease due to family history or other factors, your doctor may recommend that you start screenings earlier.

Start with your primary care provider, who should be able to tell you what tests you need and when. Most insurance plans cover most of the cost of a physical or wellness exam.

Strong recommendations from the US Preventive Services Task Force, which is the independent expert group that makes recommendations on preventive services, should be covered by most private insurance companies and are often paid for by insurers as well. federal. Recommendations from other medical groups may differ and may or may not be covered by your insurer.

“The most important thing is to have a relationship with a doctor that you see with some regularity,” says Dr. Matthew Bonzelet, an internist at Washington University in St. Louis.

Here’s a decade-by-decade guide to when to start many of the major screenings.

in your twenties

Many screening recommendations start in your 40s, but there are many that start in your 20s.

The average adult should get tested at least once in their 20s for sexually transmitted diseases such as gonorrhea, chlamydia and HIV, says Dr. A. Mark Fendrick, general internist and professor of medicine and public health at the University of Michigan. You may want to test more often depending on your risk factors, he says.

People in their twenties can also get tested for hepatitis C; the US task force recommends that adults be tested for the hepatitis C virus once in their lifetime.

Cervical cancer screenings for women at average risk are recommended from age 21 to age 65. The frequency of testing depends on the type you are doing. The task force and other groups recommend getting a cervical cytology test — often called a Pap test — every three years, from age 21 to 29.

in your thirties

For women ages 30 to 65, the task force recommends continuing with a Pap smear every three years or getting an HPV test with a Pap smear every five years. HPVs, or human papillomaviruses, cause many cervical and other cancers.

Start thinking about getting tested for diabetes and cholesterol. The task force recommends screening for prediabetes and type 2 diabetes starting at age 35 for people who are overweight or obese. But the American Diabetes Association recommends that all adults over the age of 35 get tested for type 2 diabetes, and people with higher risk factors get the blood test earlier.

According to the task force, men at average risk should have their cholesterol levels checked at age 35 and women at age 40 to see if they should take a statin, a cholesterol-lowering drug. Doctors say most people are checked earlier.

Dr. Jay-Sheree Allen, senior associate consultant in family medicine at the Mayo Clinic in Rochester, Minnesota, says she looks at a patient’s body mass index, family history of heart disease, history of personal health and lifestyle to determine when blood glucose and cholesterol screenings should be started.

“If I have a 25-year-old patient with a BMI of 40 and he tells me he has a family history of diabetes and cardiovascular disease, I test him,” says Allen.

in my forties

Women should start having mammograms for breast cancer every two years at age 40, according to the task force’s new draft guidelines. The American Cancer Society recommends that women get screened annually between the ages of 45 and 54 and every two years thereafter, while other groups recommend annual screening starting at age 40.

At age 45, it’s time to get screened for colorectal cancer, which can be done through a colonoscopy or a mail-in stool test.

If you don’t have glasses or contacts and don’t see an eye doctor regularly, the American Academy of Ophthalmology recommends seeing an eye doctor for baseline screening for eye disease when you turn 40. Go earlier if you have diabetes, high blood pressure or a family history of eye disease. Such screenings can catch diseases such as glaucoma and cataracts.

In his fifties

Postmenopausal women should be screened for osteoporosis if their healthcare provider determines they are at high risk for fractures, according to the task force guidelines.

Lung cancer screenings are recommended for adults between the ages of 50 and 80 who have smoked for 20 pack-years and who currently smoke or have quit within the past 15 years. A 20 pack-year history is equivalent to smoking one pack a day for 20 years or the equivalent, like two packs a day for 10 years.

Guidelines for screening men for prostate cancer are everywhere, doctors say, and there is no universally accepted recommendation. The American Cancer Society recommends that men over age 50 talk to a healthcare professional about the pros and cons of testing. They recommend that men whose father or brother had prostate cancer before age 65 or who are African American have this conversation starting at age 45.

In the sixties

Women 65 and older should be screened for osteoporosis with bone density tests to help prevent fractures, the task force recommends.

Men who smoke or have ever smoked should undergo a one-time screening for abdominal aortic aneurysm between the ages of 65 and 75, as recommended by the task force. Men with no history of smoking can talk to their healthcare professionals about whether they should get tested.

Some doctors begin cognitive testing in their 60s. At the Cleveland Clinic, doctors perform a minicognitive test for patients 65 and older every year or two, says Dr. Neha Vyas, a family physician at the clinic.

Write to Sumathi Reddy at [email protected]