Top 5 Screenings Every Adult Should Get by Age 45

Preventive healthcare is one of the most powerful tools we have for living longer, healthier lives. By the time you reach your mid-40s, certain health screenings can help detect silent issues before they become serious problems. Whether you feel perfectly healthy or have a family history of chronic disease, these five screenings are essential for staying ahead of the curve.

1. Blood Pressure Screening

Why it matters: High blood pressure (hypertension) often has no symptoms but significantly increases your risk of heart disease, stroke, and kidney failure. It's been called the “silent killer” for good reason.

When to test: At least once every 1-2 years, starting in your 20s. If your numbers are elevated (130/80 or higher), your provider may recommend more frequent checks or lifestyle changes and/or medication.

2. Cholesterol Panel (Lipid Profile)

Why it matters: High levels of LDL (“bad” cholesterol) and triglycerides can lead to plaque buildup in arteries, increasing the risk of heart attacks and strokes.

When to test: Starting at age 20, routinely after that depending on results. By age 45, most adults should have regular cholesterol screening, especially if they have risk factors like obesity, smoking, diabetes, or a family history of heart disease.

3. Colorectal Cancer Screening (Colonoscopy or Alternatives)

Why it matters: Colorectal cancer is one of the most preventable cancers when caught early. Polyps can be detected and removed before they become cancerous.

When to test: Adults should begin regular screening at age 45. A colonoscopy every 10 years is standard, but other options like stool-based tests (FIT or Cologuard) may be appropriate depending on risk factors and preference. A colonoscopy is possibly indicated sooner than the age of 45 if there is a family history of colon cancer. It is an important screen to discuss with your primary care provider. 

4. Breast Cancer Screening (Mammogram)

Why it matters: Early detection of breast cancer dramatically improves outcomes and survival rates. Mammograms can detect tumors before they’re felt.

When to test: Women at average risk should begin mammograms by age 40–45, and continue every 1-2 years. Those with a family history or genetic risk (such as BRCA mutations) may need to start earlier and undergo additional imaging.

5. Diabetes Screening (Fasting Glucose or A1C)

Why it matters: Type 2 diabetes can remain undiagnosed for years and may lead to nerve damage, vision loss, kidney disease, and heart disease.

When to test: In my opinion the earlier the better, especially if you're overweight or have other risk factors. Repeat every year if normal, or more frequently if borderline or elevated.

Honorable Mentions:

• Skin Cancer Checks: Annual skin exams if you have high sun exposure or a history of sunburns.

• Eye Exam: Every 1–2 years to monitor vision and screen for conditions like glaucoma.

• Pap Smear/HPV Test: For women, start Pap smears at 21 and continue through age 65, frequency depending on prior results.

Bottom Line

Turning 45 is a milestone — not just for birthdays but for proactive health. These screenings are not about fear; they're about empowerment. Early detection can save your life and help you stay active, vibrant, and healthy for decades to come.

Talk to your healthcare provider about what’s right for you based on your personal and family history. Prevention isn’t just better than cure — it’s the key to thriving.