Two things are true about health checks at once, and most writing on the subject only manages one of them. People miss free, effective tests they are entitled to. And people buy expensive tests that will, on balance, harm them. Often the same person.
The two rules this topic runs on. First: claim what you are already
owed. The NHS offers a schedule of screening by age that quietly prevents a great deal of
death, and uptake is far from complete — only about two-thirds of people return a bowel screening
kit. Second: a test is not free of risk just because it is only a test. Every screen
has a false positive rate, and every incidental finding starts a process that can end in a biopsy of
something that was never going to hurt you.
What the NHS already offers you, in England
| Age | What arrives, or what to ask for |
|---|---|
| 25–64 | Cervical screening, every 5 years. HPV testing first — if high-risk HPV is absent, nothing further is needed |
| 40–74 | NHS Health Check, every 5 years — blood pressure, cholesterol, diabetes risk, weight, and a cardiovascular risk score. You have to book it; it does not always chase you |
| 50–74 | Bowel screening, a FIT kit through the post every 2 years. Over 75 you can still request one on 0800 707 6060 |
| 50–70 | Breast screening, every 3 years. Over 70 you can self-refer and most people do not know that |
| 55–74, ever-smoked | Targeted Lung Health Check — available in parts of England and expanding |
| Men at 65 | One-off ultrasound for abdominal aortic aneurysm. A single scan that prevents deaths from a condition that is otherwise silent until it kills |
| From 65 | Vaccination becomes a health check. Shingles, pneumococcal, annual flu, COVID and RSV by the current schedule — and the shingles vaccine now has a dementia signal behind it |
| Diabetes, any age | Annual diabetic eye screening, plus foot and kidney checks |
Ages and intervals differ between England, Scotland, Wales and Northern Ireland and are revised periodically. Your invitation letter is the authority, not this table. Checked August 2026.
The argument against doing more
Why "more testing is safer" is wrong, and this is the second thing the topic says rather than a footnote
- Overdiagnosis is finding something real that was never going to harm you. It is not a false positive — the abnormality exists. It is a cancer that would never have grown, a nodule that would never have mattered. And once found, it is almost impossible not to treat.
- Scans find things. Whole-body imaging in people without symptoms turns up incidental findings in a large share of those scanned, the overwhelming majority of which are harmless — and each one generates follow-up, repeat imaging, sometimes biopsy, and a period of fear that does not fully resolve even when the answer is benign.
- The national programmes are narrow on purpose. Each starts at the age where the condition is common enough that finding it early does more good than the harm the screening itself causes. The absence of a programme is usually a decision, not an oversight — there is no national prostate screening because the evidence does not support one, not because nobody thought of it.
- A private panel that tests forty things will find something. With enough tests, a normal person produces an abnormal result by arithmetic alone — reference ranges are typically set so that one in twenty healthy people falls outside them.
What actually moves the needle, at every age
This is the uncomfortable part. The interventions that add the most healthy years are not tests. Testing tells you where you stand; it does not change where you are going.
- Not smoking, and blood pressure. Blood pressure is the most valuable number in medicine relative to what it costs to obtain — and most people measure it wrong.
- Exercise, and the emphasis has shifted. Intensity is doing more work than duration in the recent evidence — short vigorous efforts appear to buy more than the equivalent time spent walking, and even very brief bursts count. And what you need from exercise changes with age: cardiovascular in your thirties and forties, and increasingly loading for bone and resistance work for muscle from your fifties onward, because those decide independence later. See exercise and bone density.
- Diet pattern rather than any single food, and reducing the ultra-processed share is the version with most behind it. Eating for the heart.
- Sleep, alcohol and hearing. The last is the surprise: untreated hearing loss is the largest single modifiable contributor to dementia risk, and hearing aids are free.
- And from midlife, the vascular numbers matter twice over — LDL and blood pressure in your forties and fifties are dementia risk factors as well as heart ones.
How to use this topic. The decade
checklists set out what is worth doing in each ten-year block, in the same four categories each
time so they can be compared. Tests worth having and tests that are
not covers the blood panels and scans people ask about, including the ones sold privately.
Neither is a substitute for a conversation with someone who knows your history —
they exist to make that conversation more specific.