The Checkups That Matter and Why
What tests should I actually be getting?" We love this question!
And like many questions, there is no one single right answer.
Screening tests are designed to look for diseases before symptoms develop. The best screening tests are those that look for conditions that are:
Relatively common
More treatable when found early
More dangerous when discovered late
But here's something we believe strongly at GOZA:
The best screening plan isn't the one with the most tests. It's the one that's right for you.
Your age, family history, medical history, personal preferences, healthcare goals, and healthcare philosophy all matter. Two healthy 45-year-olds may have completely different screening recommendations.
Think of the guide below as a conversation starter and not a prescription.
Ages 18–39
These are the foundation of preventive health.
Blood Pressure
At least every year. High blood pressure often has no symptoms but significantly increases the risk of heart attack, stroke, kidney disease, and dementia.
Cholesterol
Most adults should have cholesterol checked beginning in early adulthood, with repeat testing based on age and cardiovascular risk. This helps identify elevated cardiovascular risk long before symptoms develop.
Diabetes Screening
Recommended earlier for adults with overweight/obesity or other risk factors, and routinely beginning around age 35 for many adults. Detecting prediabetes and insulin resistance early can often prevent progression to diabetes.
Cervical Cancer (Women)
Pap testing begins at age 21. Beginning at age 30, many women transition to HPV testing or co-testing at longer intervals. Screening dramatically reduces deaths from cervical cancer by identifying precancerous changes early.
STI Screening
Recommended based on age, sexual activity, and individual risk factors. This may include HIV, hepatitis B or C, chlamydia, gonorrhea, or syphilis.
Mental Health
Depression and anxiety screening are an important part of preventive care. Emotional health is just as important as physical health.
Vision, Dental & Hearing
Routine eye exams, dental cleanings, and hearing evaluations (when indicated) are often overlooked but play an important role in long-term health.
Ages 40–49
Continue all previous screenings plus begin discussing additional age-related screening.
Breast Cancer (Women)
Most organizations recommend beginning mammography around age 40, although method and frequency should be individualized based on family history and personal preferences.
Colorectal Cancer
Routine screening begins at age 45 for most adults. Colonoscopy remains the gold standard, but stool-based testing may be appropriate for some individuals. Screening not only detects cancer early. It can actually prevent colon cancer by identifying precancerous polyps.
Cardiovascular Risk Assessment
This is often a great decade to have a more comprehensive discussion about your long-term heart health, especially if you have a family history of heart disease or other risk factors.
Ages 50–64
Continue previous screenings. Depending on your personal risk factors, we may also recommend:
Lung Cancer Screening
Annual low-dose CT scans may be recommended for adults ages 50–80 with a significant smoking history who currently smoke or have quit within the past 15 years. Early detection can significantly improve outcomes.
Skin Cancer Evaluation
There are no universal recommendations for routine full-body skin exams in everyone, but if you have a history of significant sun exposure, numerous atypical moles, or a personal or family history of skin cancer, regular skin checks may be appropriate.
Prostate Cancer (Men)
PSA screening is one of the most individualized screening decisions. Rather than recommending it for everyone, current guidelines emphasize shared decision-making considering age, family history, race, and personal values before deciding whether screening is right for you. In general, we are fans of the PSA!
Ages 65+
Continue previous screenings as appropriate.
Osteoporosis (Women)
Bone density (DEXA) screening is routinely recommended beginning at age 65 for women and earlier for those with additional risk factors. Strong bones help preserve independence and reduce fracture risk.
Abdominal Aortic Aneurysm (Men)
A one-time abdominal ultrasound is recommended for many men ages 65–75 who have ever smoked. Detecting an aneurysm before it ruptures can be lifesaving.
What About "Extra" Screening Tests?
At GOZA, we often discuss additional testing that goes beyond standard recommendations or starting the above recommendations earlier. Many standard screening test recommendations are based on population data and cost benefits so we personalize beyond these recommendations to you!
Depending on your goals, family history, symptoms, and personal philosophy, this may include conversations about:
Coronary artery calcium (CAC) scoring
Advanced cholesterol testing (such as ApoB or Lipoprotein(a))
Bone density testing much earlier than age 65
Body composition analysis (percentage of muscle/fat mass)
Genetic risk assessment
Multi-cancer early detection blood tests (such as Galleri or Cancer Guard)
Hormone evaluation for baseline comparison or with symptoms
Blood counts and ferritin for menstruating women
These tests aren't appropriate for everyone, but they may be appropriate for you. Your annual wellness visit shouldn't just review what happened this year. It should help create a roadmap going forward, so don’t skip it!
Our Take
Preventive healthcare isn't about searching for problems. It's about staying one step ahead of them. The goal isn't to order every test available. It's to choose the right tests at the right time for the right person.
Remember, knowledge doesn't create fear. It creates options and you have options every step of the way.
To your Whole Health,
Dr. Paige Gutheil & The GOZA Wellness Team
