When Should You Get a Health Screening? A Guide by Age

María came in two weeks ago for what she thought was just fatigue. She'd been putting off her annual for almost three years — busy schedule, felt mostly fine, wasn't sure her plan covered it. We found her blood pressure at 162/98. No symptoms. No warning. Just a number that could have caused a stroke.

This happens more than I'd like to admit. People wait until something hurts, and by then we've missed the window to catch things quietly.

So here's the straight version — not a government checklist, but the way I'd walk through it with you in the exam room.

In Your 20s: If you're healthy, the priorities are blood pressure and cholesterol. Check blood pressure every year starting at 18 — hypertension is hitting younger patients in Orlando, especially in our Latino community where diet and family history make it a real risk earlier than most people think. Get a cholesterol panel at least once before age 25, then every five years after if it's normal.

If you're sexually active, talk honestly about STI screening. No judgment. Chlamydia and gonorrhea can go completely silent and cause damage you won't notice until you're trying to start a family. Women: cervical cancer screening (Pap smear) starts at 21, every three years if normal.

In Your 30s: Same as above, but now we start talking diabetes more seriously. Florida's heat keeps people inside, portions are large, and sodas are constant. If your fasting glucose is creeping toward 100 mg/dL — not technically diabetic yet — that's the time to change something, not wait.

If you have a family history of colorectal cancer, or you're Black, guidelines now recommend starting that conversation at 40, not 45. I've had patients in their late 30s where we caught things early because we didn't wait for the standard cutoff.

In Your 40s: This is the decade where the list gets real. Mammograms start at 40 — I don't care what some guidelines say about 45. I've seen what we find in that five-year window. Get one.

Colorectal cancer screening starts at 45 for average-risk adults. A colonoscopy prep is annoying. Stage 3 colon cancer is much worse.

Diabetes screening every three years if you have risk factors: overweight, family history, high blood pressure, or Hispanic heritage — which carries statistically higher type 2 diabetes risk. Blood pressure every year. Cholesterol every four to six years if normal.

In Your 50s and Beyond: If you've smoked — 20 pack-years or more — low-dose CT for lung cancer screening starts at 50. Most people don't get this because no one brings it up. I'm bringing it up.

Bone density scan at 65 for women, earlier if you have risk factors like long-term steroid use or a family history of fractures. Shingles vaccine at 50 — this is one I push hard. If you've had chicken pox, the virus is already in your system, and Central Florida's heat doesn't make things better. And if you're a male smoker between 65 and 75, one abdominal ultrasound for aortic aneurysm screening. One.

When to Come In Before Your Annual: Chest pain lasting more than a few minutes. Blood in your stool or black tarry stools. A breast lump or nipple discharge. Unexplained weight loss of 10 or more pounds. Shortness of breath that keeps getting worse. Blood in your urine. A mole that's changed in size, shape, or color.

And if something just feels off and you can't explain it — that's reason enough. Trust your gut.

Most of what I've listed isn't dramatic. It's a blood draw and a conversation. But that's how we find things quietly, early, when we can actually do something. For a deeper look at specific screenings by condition, our health resource partner VitaGuia (vitaguia.com) covers many of these in more detail.

If you're not sure what you're due for — or you've been putting it off because of cost, schedule, or just not knowing where to start — come see us at Lake Nona Medical Services. Two locations in Orlando, walk-ins welcome, and Spanish spoken. Dr. Arevalo and the team will look at your full picture and tell you what's overdue, what can wait, and what's actually worth worrying about.

We'd much rather see you now than after something goes wrong.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.