Mon Jan 3

I'm approaching a 'milestone' birthday. What health checks should I have at my age?

Written by: Natasha Yates, Assistant Professor, General Practice, Bond University

Haven’t had a health check in a while, or ever?

You’re not alone. Most people wait until they’re sick to see a GP, so there’s not usually much time in a consultation to also talk about preventative health.

So, should you book a check with your GP just to talk about what you can do to stay well? And if so what should you be discussing?

It depends on your life stage.

Doctors won’t check you for everything

It may surprise you there is no evidence ^[1] that a “general health check-up” will give you better health outcomes.

Some preventive checks in low-risk and otherwise well patients have shown no benefit ^[2], including some blood tests and imaging investigations, such as whole body CTs or MRIs for cancer screening.

As well as being a waste of your time and money, there is another concern with generic health screening: it may lead to overdiagnosis ^[3], which results in additional tests, appointments, anxiety, drugs and even operations. Ironically, this can leave you less healthy.

This is why doctors don’t “check you for everything”, but are guided by what you personally would benefit from, based on your individual history, as well as which tests have evidence for their benefits outweighing any harms.

One of your doctor’s key considerations will be your age.

Young adults (20–30s)

The main evidence-based screening check for young adults is the cervical screening test ^[5] for women. This is a five-yearly cervical swab which looks for the human papillomavirus (HPV) and pre-cancerous cells.

When young women present for their cervical smear test, several other important preventative discussions often take place, including pregnancy prevention or planning.

As young men don’t need an equivalent screening test, they often miss out on the chance to talk about prevention.

Two men at work look at their computers.

Young men might need to be more proactive about seeing a GP in their 20s and 30s. Annie Spratt/Unsplash ^[6]

Both men and women in this age group should find a GP with whom they feel comfortable discussing STI (sexually transmitted infection) checks, skin cancers, mental health struggles ^[7] and intimate partner violence.

Even otherwise fit and healthy young adults should consider talking with their GP about what they can do to prevent chronic disease down the track. Health behaviours such as diet, sleep, smoking and exercise levels in young adulthood increase or decrease the risk ^[8] of developing conditions such as diabetes, heart disease, strokes, and cancer down the track.

Finally, regular checks from dentists and optometrists can pick up problems early.

40–50 year olds

Despite the adage “life begins at 40”, this is the age at which many of the things that can cause an early death are worth screening for.

Current evidence shows ^[9] benefits in assessing your blood pressure, cholesterol, and risk of heart disease, diabetes, kidney disease and skin cancer.

If you have a higher risk for certain cancers (such as breast or colorectal cancer), then screening for these may start around this age too.

It’s also not too late to improve your longevity with some lifestyle changes so discussing things like losing weight, stopping smoking, and improving your exercise are all important.

As with young adults, women should continue getting a cervical smear test every five years.

And everyone should consider getting checked by a dentist and optometrist.

Mental health may deteriorate around this age too, because the strain from looking after children, ageing parents and demanding careers can all come to a head. Input from a psychologist may be helpful.

50–65 year olds

Patients often comment on the 50th “birthday present” they find in the mail: a stool sample collection kit for colorectal cancer screening. While it’s not the highlight of your 50s, it is effective in saving lives ^[11] through early detection of this cancer, with checks recommended every two years.

Women will also be invited to start mammograms for breast cancer screening every two years ^[12] (unless they have already started in their 40s, depending on their individual risk).

Women will be screened for a breast cancer, colorectal cancer and osteoporosis. Shutterstock ^[13]

The third health issue to start screening for in your 50s is osteoporosis, a condition where bones become fragile and your risk of a fracture increases. Osteoporosis is painless and therefore often not discovered until too late. You can start checking your risk for this at home via an online calculator, such as this one ^[14] from the Garvan Institute.

Oral health and eye checks remain important in this age group as well.

Over-65s

Several immunisations are recommended from the age of 65 ^[15], including shingles and influenza, as your immunity starts to wane and your risk of serious illness increases.

Other preventative checks include those for your vision, dental health, hearing, and your risk of falls. These often involve allied health providers who can screen, monitor and treat you as needed.

Some of your other regular screening will stop in your mid-70s, including for colorectal, cervical and breast cancer.

First Nations people

The above age-related recommendations are for those with standard risk factors. First Nations Australians are at higher risk of developing a range of diseases including diabetes, heart disease, kidney disease and certain cancers.

Aboriginal and Torres Strait Islander people may be offered more thorough screening ^[17], according to a different timeline, with some checks at earlier ages.

While annual generic “health checks” aren’t recommended, a conversation with your GP will help you work out your specific health risks and screening needs.

Prevention is better than a cure, so make sure you’re accessing evidence-based screening and preventative strategies that are right for you.