Each decade uses the same four headings, so they can be read against each other: bloods, screening, worth asking about, and what actually matters — which is deliberately last and deliberately the largest.
Before the lists. These are for people without symptoms.
Anything new, persistent or unexplained goes to a GP now rather than waiting for a scheduled check
— screening programmes are designed for well people and are the wrong route for a symptom.
Ages are for England and are revised periodically; your invitation letter is the authority.
Checked August 2026.
Twenties — Almost nothing, and that is the correct answer
| Bloods | No routine panel is indicated. A one-off baseline is reasonable if you have a strong family history of early heart disease or a condition that runs in the family. Otherwise a blood test in a well 25-year-old mostly generates incidental abnormalities that resolve on repeat. |
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| Screening | Cervical screening from 25, five-yearly, and it is the single most valuable thing in this decade. Uptake in this age group is the lowest of any. |
| Worth asking about | Vaccination status — HPV, MMR, and travel cover. Contraception and preconception advice, including folic acid before rather than after conception. Sexual health screening at intervals that match your circumstances. |
| What actually matters | Peak bone mass is built now and cannot be built later — loading exercise in this decade decides how much you have to lose from. Smoking status, alcohol pattern and the habits that become permanent. And a blood pressure reading once, so a baseline exists. |
Thirties — Establish the numbers you will be tracking for the next forty years
| Bloods | Still no routine panel. Reasonable to have a lipid profile once if there is any family history of premature cardiovascular disease — and if it is markedly abnormal, familial hypercholesterolaemia is worth excluding, because it is common, treatable and usually diagnosed decades late. See genetics. |
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| Screening | Cervical screening continues. Nothing else is offered nationally and nothing else is warranted without a reason. |
| Worth asking about | Blood pressure at least once, measured properly. Preconception health for either partner. Mental health, which peaks in burden in this decade and is under-presented. |
| What actually matters | This is where the exercise emphasis is most worth getting right. Vigorous intensity beats duration for cardiovascular benefit, and adding resistance work now costs nothing and pays off in your sixties. Weight gained through this decade is disproportionately hard to lose later. |
Forties — The decade the evidence actually changes
| Bloods | From 40, via the NHS Health Check: cholesterol, blood glucose or HbA1c, and kidney function. Every five years is the offer. Worth asking additionally about Lp(a) once in a lifetime — it is genetically determined, never needs repeating, and identifies a group at substantially higher risk who would otherwise look ordinary. See what to test. |
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| Screening | NHS Health Check from 40 — and you generally have to book it. Cervical screening continues. Breast screening trials extend to some women from 47. |
| Worth asking about | A cardiovascular risk score, which is the point of the Health Check. Whether a calcium score would change your decision, if you are in the grey zone where a statin is arguable. Diabetes risk if there is family history or raised waist circumference. |
| What actually matters | Midlife LDL and blood pressure are dementia risk factors as well as heart ones, and the Lancet Commission dates that exposure from about 40. Bone loss begins to be measurable. Hearing is worth a baseline if you have had noise exposure. |
Fifties — Most of the national programmes start here
| Bloods | Health Check continues five-yearly. Thyroid function if symptomatic — and it frequently is mistaken for menopause or ageing. Ferritin in anyone with heavy periods or unexplained fatigue. HbA1c if risk factors are present. Vitamin D from October to March is a supplement question rather than a testing one for most people. |
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| Screening | Bowel screening from 50, every two years by post. Breast screening from 50, every three years. Lung health check from 55 if you have ever smoked, where available. Cervical screening continues to 64. |
| Worth asking about | Menopause, and it belongs in this list. The risk conversation changed substantially after the original WHI reporting. But the guard matters: HRT is a symptom-led decision and is not prescribed to prevent heart disease. What vascular risk factors change is the choice and the route — which preparation, and transdermal against oral — which is precisely why this conversation belongs with a prescriber who knows your history rather than with a checklist. Prostate: there is no national screening programme, and the reason is that PSA finds cancers that would never have caused harm — but you can request a PSA test from 50 and are entitled to a discussion about what it will and will not tell you. |
| What actually matters | Resistance and impact loading move from optional to central. Bone density falls fastest around menopause, and the loading that protects it is specific — see bone. Hearing testing. And this is where the vascular numbers stop being theoretical. |
Sixties — Claim everything, and start protecting function
| Bloods | Health Check to 74. Kidney function matters more as medication load rises. B12 if you take metformin or a long-term PPI, both of which deplete it and both of which are common. Full blood count if fatigued — anaemia in this age group needs a cause, not a supplement. |
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| Screening | Men: the one-off AAA ultrasound at 65. It is a single scan, it takes minutes, and it prevents deaths from something otherwise silent. Breast screening to 70, then self-refer — which most people do not know they can. Bowel screening continues. Eye test at least every two years: free from 60, and untreated vision loss is a dementia risk factor. |
| Worth asking about | Vaccination becomes a genuine intervention: shingles, pneumococcal, annual flu and COVID, and RSV by the current schedule. Atrial fibrillation — check your own pulse, or use a device that does; AF is common, often silent, and anticoagulation prevents strokes. Bone density scan if you have fractured, or have risk factors. |
| What actually matters | Strength, balance and hearing. Those three decide whether the next twenty years are independent. Falls prevention starts before the first fall. |
Seventies and beyond — Fewer tests, more function
| Bloods | Less becomes more. Reviewing medication is worth more than adding tests — polypharmacy is a bigger threat at this age than most undiagnosed disease. Kidney function and electrolytes matter because so many drugs act on them. Ask what each tablet is for and whether it is still needed; that conversation has a name, deprescribing, and it is legitimate to request it. |
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| Screening | Bowel screening ends at 74 but can be requested every two years afterwards on 0800 707 6060. Breast screening by self-referral. And screening genuinely does become less useful with age, because the lead time needed for benefit starts to exceed remaining life expectancy — that is not a judgement about anyone's worth, it is arithmetic, and it is the reason programmes have upper ages. |
| Worth asking about | A structured medication review. Bone protection if you have fractured. Hearing and vision, again, because they drive isolation and dementia risk. Continence, which is common, treatable and almost never raised. |
| What actually matters | Resistance training has more evidence at 75 than at 25 — muscle mass and balance are the difference between independence and not, and gains are achievable at any age. Protein intake needs to be higher, not lower. Social contact is a health intervention with real evidence, not a nicety. |
The one that applies to every decade
- Blood pressure. At any age, measured properly, and more often than most people do it. How to get a number worth having.
- Know your family history and write it down. Premature heart disease, cancers and their ages, and anything that recurred. It changes which of the above applies to you, and most people have never assembled it.
- Dental checks. Left off almost every list of this kind, and among the few genuinely worth having at every age.
- And the intervals above are defaults for people at average risk. A family history, an existing condition, a medication or an occupational exposure changes them — which is exactly the conversation these lists are meant to start.