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 (HPV test)
21–29, every 3 years (a smear (cytology) every 3 years); 30–65, every 5 years (an HPV test every 5 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 evidence says
Grade A (2018): a smear every 3 years from 21 to 29; from 30 to 65, an HPV test every 5 years, or a smear every 3. A 2024 draft adding self-collected HPV tests is not yet final.
45–75, every year (a FIT every year, or a colonoscopy every 10 years); 76–85, every year (76 to 85: decide with your doctor)
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.
24–28per 1,000
bowel cancer deaths avoided per 1,000 people screened from 45 to 75, modelled estimate (US)
modelled estimate
What the evidence says
Grade A from 50 to 75, grade B from 45 to 49 (2021): a FIT every year, a colonoscopy every 10 years, or another approved test. From 76 to 85, selectively.
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
Grade A (2021): all adults from 18; every 3–5 years from 18 to 39 if normal, every year from 40.
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
Grade B (2022): a statin for adults 40 to 75 with a risk factor and a 10-year risk of 10% or more, which means checking cholesterol and risk.
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
Grade B (2019): one scan for men aged 65 to 75 who have ever smoked; for men who never smoked, selectively.
Prostate cancer, including many small tumours that would never have caused harm.
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
Grade C (2018) from 55 to 69: an individual decision after talking to a clinician. Grade D from 70: do not screen.
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.
What preventive screenings are covered at no cost?
Tests the US Preventive Services Task Force grades A or B must be covered at no cost by most private plans: blood pressure, cholesterol and statin assessment from 40, diabetes testing from 35 if overweight, colorectal screening from 45, mammograms every 2 years from 40, cervical screening from 21, lung CT for heavy smokers from 50, an aortic scan for men 65–75 who ever smoked, bone density for women from 65, and hepatitis C and HIV once.
What screenings should I get at 40?
Women: Cervical screening (HPV test), Breast screening (mammogram), Blood pressure, Cholesterol and 10-year heart risk, Hepatitis B and C (one test), HIV (one test), Blood sugar test for diabetes. Men: Blood pressure, Cholesterol and 10-year heart risk, Hepatitis B and C (one test), HIV (one test), Blood sugar test for diabetes.
What screenings do I need at 50?
Women: Cervical screening (HPV test), Breast screening (mammogram), Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart risk, Hepatitis B and C (one test), HIV (one test), Blood sugar test for diabetes. Men: Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart risk, Hepatitis B and C (one test), HIV (one test), Blood sugar test for diabetes. Smokers with 20 pack-years add a yearly lung CT from 50.
What screenings do I need after 65?
Women: Cervical screening (HPV test), Breast screening (mammogram), Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart risk, Bone density scan (DEXA), Hepatitis B and C (one test), HIV (one test), Blood sugar test for diabetes. Men: Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart risk, Hepatitis B and C (one test), HIV (one test), Blood sugar test for diabetes. A PSA test is a decision to make with your doctor. Smokers with 20 pack-years add a yearly lung CT from 50.
Is a full-body scan or yearly 'complete' check-up worth it?
Usually not. A Cochrane review of 17 trials found general health checks made no difference to deaths, and the FDA knows of no evidence that whole-body scans in people without symptoms do more good than harm. What matters is the screening that fits your age, most of it covered at no cost.
The evidence column follows the US Preventive Services Task Force (USPSTF) recommendations and grades. Grade A or B means most non-grandfathered private plans must cover the test in-network at no cost to you; in June 2025 the Supreme Court upheld the way the Task Force is appointed, which keeps that rule in place. Medicare and Medicaid have their 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.
Sources
Every rule and number on the page, with its source. Checked on 27 September 2026.