Sudden, severe pain in the belly or back in an older person is an emergency, not an appointment: call 112.
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.
FIT kitBlood pressureCholesterolBlood sugarHIV
At 71
Stops: Blood sugar test for diabetes
At 75
Stops: Bowel cancer screening (FIT kit)
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.
Bowel cancer screening (FIT kit)
50–69, every 2 years; 70–74, every 2 years (depends on your region)
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.
If a parent, brother, sister or child had bowel cancer, don't wait for the programme: colonoscopy starts at 40, or 10 years before the age your relative was diagnosed, whichever comes first. Tell your doctor.
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 evidence says
A stool test for hidden blood every 2 years. Order SND/356/2026 widened it from 50–69 to 50–74; regions have 5 years to start and 10 years to invite everyone aged 70–74.
18–39, every 3 years (or every 5 years if normal); from 40, every year
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 evidence says
Spanish family medicine (PAPPS): every year from 40; before that, every 3–5 years.
How to get it
At your health centre (centro de salud), with your family doctor, free under the national health system; no letter comes, you ask at a visit.
Cholesterol and 10-year heart and stroke risk
from 18, every 4 years
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 evidence says
European prevention guideline (ESC, 2021): risk assessment may be considered in men over 40 and women over 50. Spanish family medicine checks cholesterol at least every 4 years.
25–34, every 3 years (a smear (cytology)); 35–65, every 5 years (an HPV test)
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 evidence says
From 25 to 34, a smear every 3 years; from 35 to 65, an HPV test every 5 years (Order SCB/480/2019). Regions must reach full coverage by 2029.
45–49, every 2 years (depends on your region); 50–69, every 2 years; 70–74, every 2 years (depends on your region)
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 evidence says
A mammogram every 2 years from 50 to 69. In May 2026 the national public health commission approved widening it to 45–74; regions will have years to put it in place.
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 evidence says
No screening programme; only research pilots.
How to get it
Men over 65 who have smoked can ask their family doctor for an abdominal ultrasound.
PSA test for prostate cancer
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 evidence says
No screening programme. Spanish family doctors' 'do not do' list advises against routine PSA in men without symptoms.
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, once thyroid ultrasound was added to routine checks, thyroid cancer diagnoses rose fifteenfold in 18 years while deaths stayed flat. Of those operated on, 11% were left with damaged parathyroid glands.
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.
Free through your region: a smear every 3 years from 25 to 34 and an HPV test every 5 years from 35 to 65; a mammogram every 2 years from 50 to 69 (45–74 is being added); a stool test every 2 years from 50 to 69 (74 by law, phased in). Blood pressure and cholesterol are checked by your family doctor; HIV testing is free.
Which tests should you have at 40?
Women: Cervical screening, Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, HIV, one-time test. Men: Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, 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, 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, HIV, one-time test. Heavy smokers should ask their family doctor; lung screening is still a pilot.
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, 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, HIV, one-time test. Heavy smokers should ask their family doctor; lung screening is still a pilot.
Is a private full check-up worth it?
Usually not. Spanish family doctors advise against routine PSA and bone density scans in people without symptoms, and a Cochrane review of 17 trials found general health checks made no difference to deaths.
The evidence column follows the national screening orders published in the BOE, the Ministry of Health and the Spanish family-medicine preventive programme (PAPPS); for the size of each benefit, the randomised trials and the US Preventive Services Task Force evidence reviews. Where Spain has no programme, the page says so.
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. Screening finds disease early; it does not prevent it. 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.