Screening at your age: benefits, limits and access
Choose your age and sex: see what matters now, what comes next, and what your statutory health insurance already pays for.
A guide for adults without symptoms. Some tests can reduce deaths; others have benefits measured through fewer complications or treatment after detection. Outcomes differ between tests; discuss your choice with a clinician.
Sudden, severe pain in the belly or back in an older person is an emergency, not an appointment: call 112. At night and at weekends, the on-call doctor service is 116 117.
What gets added in the years ahead
Each line is a test; each dot is an appointment. Scroll and your age goes up: see what starts and stops at each birthday.
Cervical screening, every 3 years (Pap smear plus HPV test every 3 years)
Blood pressure, every 3 years (at the Check-up 35)
Cholesterol and 10-year heart and stroke risk, every 3 years (at the Check-up 35)
Blood sugar test for diabetes, every 3 years (at the Check-up 35)
Hepatitis B and C, one-time test, once, if never done (at the Check-up 35)
Skin cancer check, every 2 years
At 50
Breast screening (mammogram), every 2 years
Bowel cancer screening (FIT kit), every 2 years (or two colonoscopies 10 years apart)
At 76
Stops: Breast screening (mammogram)
After 74–75 most screening is no longer recommended routinely, because its benefit takes years to arrive. Whether to continue is a decision with your doctor, based on your health and wishes.
What each test is worth
The same question for each: per 1,000 people, how many deaths from the disease does the test prevent? Some numbers come from trials (people invited, or randomly assigned to the test), others from a model that assumes people always attend; each has its own time span, written beside it. For osteoporosis the number is hip fractures, not deaths. So the tests are not ranked on one scale.
Each small square is a person; there are 10,000.
Cervical screening
20–34, every year (a Pap smear every year); from 35, every 3 years (Pap smear plus HPV test every 3 years)
High-risk types of HPV, which over years can turn cells of the cervix into cancer. A positive test leads to a check of the cells and, if needed, a colposcopy, where changes are found before they become cancer.
8per 1,000
cervical cancer deaths avoided per 1,000 women with an HPV test every 5 years from 30 to 65, compared with none: from 8.34 to 0.29 (modelled estimate, US)
modelled estimate
What the rules provide
From 20 to 34, a Pap smear every year; from 35, a Pap smear together with an HPV test every 3 years, with no upper age limit.
18–34, once, if never done (at the Check-up, once between 18 and 34); from 35, every 3 years (at the Check-up 35)
High blood pressure, which causes no symptoms and raises the risk of heart attack and stroke.
no death count for the test
No trial compares people whose blood pressure was measured with people whose was not. The benefit comes from treatment, which clearly cuts heart attacks and strokes.
What the rules provide
Measured at the health Check-up: once between 18 and 34, then every 3 years from 35.
Anonymous at the local health office (Gesundheitsamt), free or for a small fee, and at community checkpoints; your doctor's test is covered by insurance when there is a concrete reason.
Breast cancer while it is small, before it can be felt.
4.3per 1,000
breast cancer deaths prevented per 1,000 women invited from 50, over 20 years
estimated from 11 trials
12.9 cancers found that would never have caused harm (overdiagnosis)
What the rules provide
A mammogram every 2 years from 50 to 75; the upper age was raised from 69 to 75. The G-BA is considering a start at 45; there is no entitlement yet. From 30, the yearly gynaecological check includes a breast examination by hand.
Free. One of 14 regional centres (Zentrale Stellen) invites you; women aged 70 to 75 can also book themselves. You can book if your last screening mammogram was at least 22 months ago. In 2023, 52% of women invited took part.
from 50, every 2 years (or two colonoscopies 10 years apart)
Invisible traces of blood in stool, a sign of polyps and bowel cancer. A positive test leads to a colonoscopy, where polyps can be removed there and then.
A family history of bowel cancer can change which screening is right for you. Tell your doctor which relatives had bowel cancer and how old they were when diagnosed; screening options depend on that history.
24–28per 1,000
bowel cancer deaths avoided per 1,000 people screened from 45 to 75, modelled estimate (US)
modelled estimate
The model assumes a FIT every year (or a colonoscopy every 10 years) from 45. The programme here, every 2 years from 50, prevents somewhat fewer deaths.
What the rules provide
From 50, women and men choose: a stool test (FIT) every 2 years, or two colonoscopies 10 years apart. Since April 2025 women can have the colonoscopy from 50, like men.
Free. Your insurer invites you at 50, 55, 60 and 65. The stool test comes from your family doctor or gynaecologist; the colonoscopy is done by a gastroenterologist.
Your chance of a heart attack or stroke in the next 10 years, worked out from cholesterol, blood pressure, age and smoking.
no death count for the test
The benefit comes from treatment: in 18 trials of adults with no previous heart attack or stroke, statins meant about 3.5 fewer deaths per 1,000 people treated, over 6 months to 6 years.
What the rules provide
Cholesterol is measured at the Check-up every 3 years from 35.
Free with statutory insurance (GKV): a dermatologist or a trained family doctor (Hausarzt) looks at all your skin, scalp included. The doctor may use a dermatoscope; since April 2020 it is part of the insured service and may not be charged separately.
Lung cancer at a stage when it can still be operated on.
3per 1,000
lung cancer deaths prevented per 1,000 heavy smokers scanned yearly, over about 7 years, compared with chest X-ray (NLST)
measured in a trial
Nearly a quarter of scans come back positive at first; almost all turn out to be false alarms.
What the rules provide
Since April 2026: a low-dose CT scan every year from 50 to 75 for current and former heavy smokers, with at least 25 years of smoking, at least 15 pack-years, and smoking breaks (a quit included) of no more than 10 years.
Free with statutory insurance. A participating family doctor or internist checks whether you qualify and talks it through; an approved radiology practice does the scan.
A swelling of the main artery in the abdomen that causes no pain and no signs until it bursts.
4.6per 1,000
aneurysm deaths prevented per 1,000 men invited to one scan, over 13 years (MASS trial)
measured in a trial
In December 1948 the surgeon Rudolph Nissen opened Albert Einstein's abdomen in Brooklyn and found a large aneurysm on the aorta. There was no way to replace it, so he wrapped it in cellophane to stiffen it. Einstein lived six more years. In April 1955 the aneurysm burst; he refused surgery and died on 18 April. Today the same swelling shows up on a scan that takes a few minutes.
What the rules provide
Men from 65: one ultrasound scan of the abdominal aorta.
Prostate cancer, including many small tumours that would never have caused harm.
If your father or brother had prostate cancer, or you are of African descent, the PSA conversation starts at 45; with a BRCA2 mutation, at 40 (European urology guideline, EAU).
2.2per 1,000
prostate cancer deaths prevented per 1,000 men aged 55–69 invited to PSA testing, over 23 years (ERSPC)
measured in a trial
More than 45% of men tested at every round had at least one false positive over 10 years, and 20–50% of the cancers found would never have caused harm.
What the rules provide
Statutory insurance pays for a yearly rectal examination from 45, not for the PSA blood test. The 2025 German prostate cancer guideline now advises against the rectal examination and suggests a baseline PSA from 45 for men who choose testing.
Osteoporosis: bones that break in an ordinary fall.
5per 1,000
hip fractures prevented per 1,000 older women, over 4–5 years (three trials)
measured in trials
What the rules provide
No screening programme. Bone density measurement is paid when there is a specific reason: a fracture without major trauma, or a raised risk where the result would decide on treatment.
What insurance pays
With a specific reason, free on referral; purely as a check-up, it is usually a self-paid extra (IGeL).
What isn't worth the money
Private clinics sell 'complete' check-ups. The tests below often appear in them and have no evidence of saving lives in people without symptoms and at average risk; some cause harm. Symptoms need a doctor, not a screening list.
Tumour markers (CEA, CA-125, CA 19-9, CA 15-3, AFP) without symptoms
In two large trials of CA-125, women who were tested were no less likely to die of ovarian cancer. Between 1% and 3% had surgery without having cancer, and up to 15% of those had serious complications.
In South Korea, the thyroid cancer diagnosis rate rose fifteenfold between 1993 and 2011, mainly through detection of papillary cancers; mortality stayed stable. An insurance-claims analysis of more than 15,000 Koreans who underwent surgery reported hypoparathyroidism in 11%: their parathyroid glands were not working properly. The article does not specify how many cases were permanent.
The US Food and Drug Administration says it knows of no evidence that whole-body scanning of people without symptoms does more good than harm. It finds 'something' in many people, and each finding leads to more tests.
A Cochrane review of 17 trials with over 230,000 people found no difference in deaths between people invited to general health checks and those who were not. What matters is the tests that fit your age, not how many.
The independent IGeL-Monitor rates ovarian ultrasound for cancer detection 'negative', and the PSA test, thyroid ultrasound and blood tests, and eye-pressure checks for glaucoma 'tends to be negative'.
Which screening does statutory health insurance pay for in Germany?
Statutory insurance (GKV) pays for: the Check-up once between 18 and 34 and every 3 years from 35 (blood pressure; from 35 also cholesterol, blood sugar and a one-time hepatitis B and C test); cervical screening from 20; a skin check every 2 years from 35; a mammogram every 2 years from 50 to 75; a stool test every 2 years or two colonoscopies from 50; a rectal examination for men from 45; one aortic scan for men from 65; and, since April 2026, a yearly lung CT for heavy smokers from 50 to 75.
Which check-ups should you have at 40?
Women: Cervical screening, Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. Men: Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test.
Which screening should you have from 50?
Women: Cervical screening, Breast screening (mammogram), Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. Men: Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. The PSA test is self-paid (IGeL) and a decision to make with your doctor. Heavy smokers from 50 to 75 add a yearly low-dose lung CT.
Which screening should you have from 65?
Women: Cervical screening, Breast screening (mammogram), Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. Men: Bowel cancer screening (FIT kit), Abdominal aortic aneurysm (AAA) scan, Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. The PSA test is self-paid (IGeL) and a decision to make with your doctor. Heavy smokers from 50 to 75 add a yearly low-dose lung CT.
Are self-paid extras (IGeL) worth it?
Mostly not. The independent IGeL-Monitor rates ovarian ultrasound 'negative', and the PSA test, thyroid checks and glaucoma eye-pressure tests 'tends to be negative'. A Cochrane review of 17 trials found general health checks made no difference to deaths. What matters is the screening that fits your age, which insurance already pays for.
The evidence column follows the directives of the Federal Joint Committee (G-BA), which decide what statutory health insurance (GKV) pays for, and the German cancer information service (Krebsinformationsdienst). The size of each benefit comes from the randomised trials and the US Preventive Services Task Force evidence reviews. Private insurance (PKV) usually pays for the same tests, with its own rules.
Lives saved are absolute: deaths avoided per 1,000 people, not '42% fewer'. Some come from trials (people invited, followed for a fixed number of years), others from models that assume you take every test for life. They are labelled separately and not ranked.
This page does not replace your doctor. With symptoms, a family history of cancer or a long-term condition, your list is different and is made with them.
Why the ages change
Screening ages move when the evidence moves, and lately they have moved down because some diseases now appear earlier: in 2021 the US lowered bowel screening from 50 to 45 as bowel cancer rose in younger adults, and diabetes testing from 40 to 35; Spain and Austria widened their programmes in 2025–2026. Every rule here was checked in September 2026. Some programmes can prevent cancer by finding and treating precancerous changes; others aim to detect disease early. The other half stays the same: not smoking, a healthy weight, moving more and drinking less.
Sources
Every rule and number on the page, with its source. Checked on 27 September 2026.