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A letter from the clinic says you're due for a check. A friend your age just had a scan that found something. Your partner keeps asking when you last had your skin looked at.
And somewhere in a drawer is a bowel test kit you meant to send back.
Nobody hands you the list of which checks are worth doing, at what age, and how often. So most of us do the ones we get nagged about and skip the rest.
About a dozen checks have good evidence behind them, and the ones that save the most lives are the ones people put off the longest.
Pope Leo had part of a lung removed for cancer in October, and he's believed never to have smoked, which set off a round of "should everyone be scanned?" On The Cancer Letter's podcast on October 21, the editors made the opposite case: a test is only worth having if it's been shown to help people like you, and the US body that judges that, the Preventive Services Task Force, is being stripped back.
Today: the screening calendar, by age and sex, with what each test can and can't tell you.
Wednesday: the checks that can do more harm than good, including full-body scans.
Friday: your personal schedule on one page, to take to your doctor.
The blood tests on the calendar are the ones in the Bloodwork Cheat Sheet, with the words to ask for them.
The Evidence
The ages are the US Task Force's, which most countries work from. Where the UK, Canada or Australia differ, we say so. Three groups: the yearly ones, the once-only ones, and the ones that start at an age.
Every year.
Blood pressure. A home cuff is fine, and it's one of the numbers you can change the most. We covered how in the blood pressure issue.
ApoB. Ask for ApoB with your normal bloods. The count of cholesterol particles that can get into an artery wall, and a better guide than standard LDL. The words to use are in Ask for these three by name.
HbA1c from 35, if you carry extra weight. Your 3-month blood sugar average. The Task Force starts it at 35 for anyone overweight, because prediabetes is reversible and most people who have it don't know.
A skin check. Look over your own skin every few months, the Cancer Council way: whole body, good light, a mirror or a partner for your back. Book a yearly check with a doctor if you're fair, have lots of moles, burned badly as a kid, or have had a skin cancer before. The US Task Force says the evidence for checking everyone isn't there yet. Australia, with the highest melanoma rates in the world, checks the high-risk group yearly.
Once in your life.
Lp(a). A cholesterol particle set by your genes that doesn't move with diet, so one test tells you for good. About 1 in 5 people carry a high level and most don't know. We covered what to do with the result in the Lp(a) issue.
An aortic ultrasound for men 65 to 75 who ever smoked. A 10-minute scan for a bulge in the main artery that kills quickly if it bursts. In 4 trials of 134,000 men, being invited for the scan cut deaths from it by about 35%.
From an age.
40: a proper eye exam, then every 1 to 2 years from 65. Glaucoma has no symptoms until sight is gone, and the pressure test takes a minute. That's the American Academy of Ophthalmology's schedule.
40: mammogram every 2 years to 74, for women. The Task Force moved the start to 40 in 2024. For every 1,000 women screened that way, about 8 breast cancer deaths are prevented. The cost is call-backs that turn out to be nothing, and most women get at least one. The old worry, that mammograms find cancers that would never have hurt you, was cut down to size in September: a reanalysis of all 8 mammography trials in the Journal of the National Cancer Institute put it under 5%, not the 30% that gets quoted. Cervical checks every 3 to 5 years to 65 sit alongside.
40: a heart calcium scan, worth considering if your ApoB or LDL is still high after changing how you eat and live, or you've been offered a statin and want to see what's in your arteries. A quick CT that counts hardened plaque, $100 to $400 in the US. The 2026 US guideline backs it for men from 40 and women from 45 when the statin decision is unclear. A score of 0 makes it reasonable to hold off and rescan in 3 to 7 years. We went through the scores in Should you get a heart calcium scan?
45: bowel screening to 75. A stool test every 1 to 3 years or a colonoscopy every 10. It has the best evidence of any test here and the most people skip it. In the biggest trial to date, NordICC in NEJM, only 42% of people invited to a colonoscopy turned up. Among those who did, cancer deaths were about half those of people who weren't screened. The UK and Canada start at 50. The US and Australia moved to 45 because bowel cancer in younger adults is climbing: the American Cancer Society's 2026 report puts the rise at about 3% a year in people 20 to 49, and it's now a leading cause of cancer death under 50. If you're in your late 30s or early 40s and it's in your family, or you'd just rather know, a stool test is cheap and worth asking for early.
50: a yearly lung CT, only if you smoked. 20 pack-years (a pack a day for 20 years, or 2 a day for 10), and you still smoke or quit within 15 years. It cut lung cancer deaths by about 20% in the big US trial. About 1 in 4 scans flags something harmless, which is why it's not offered to never-smokers, the Pope included.
55 to 69: PSA, for men, after a proper conversation. Per 1,000 men screened, about 1 avoids dying of prostate cancer and 3 avoid it spreading, while 50 end up with sexual problems and 15 with incontinence from treatment. Some men will take that trade, especially with a family history. It just shouldn't happen without you knowing those numbers. The Task Force says don't bother over 70.
65: a bone density scan for women, and a hearing check for everyone. Bone earlier if you broke a bone after 50 or went through menopause early, per the 2025 guidance and our bone density issue. Hearing as soon as you notice the TV creeping up: untreated hearing loss is one of the biggest changeable risks for dementia, which we covered in July.
That's the whole list. For a non-smoker it works out to a handful of appointments a decade, and 2 of them only ever happen once.
You'll notice what isn't on it. Full-body MRI scans like Prenuvo, the yearly "executive" check-up, and the new blood tests that claim to spot 50 cancers at once. Wednesday is about why they didn't make the cut.
What This Means For You
Here's how to use the calendar.
Check off what you've had. Most people over 50 are missing 1 or 2.
Book the once-only tests first. Lp(a) for everyone, and the aortic scan for men who smoked. Easiest to clear, and you never think about them again.
Add the yearly ones to your normal bloods. ApoB and HbA1c go on the same form as everything else. You just have to ask.
Move earlier if a parent or sibling had it. A first-degree relative with bowel, breast or prostate cancer, melanoma, or a broken hip usually means starting 10 years before their age at diagnosis. Say so when you book.
In the UK and Australia, check your letters. The NHS and the Australian program post the bowel kit and invite you for breast and cervical checks. The eye, hearing, skin, ApoB and Lp(a) tests you book yourself.
One honest caveat. Screening looks for trouble in people who feel fine, so it sometimes finds things that would never have hurt you, and treating those has risks of its own. Every test above has been through that weighing, harm against lives saved, before it got a recommendation. The scans we'll cover on Wednesday mostly haven't.
Save the calendar, or forward it to whoever in your house keeps putting off their check.
If you want the blood tests in the right words for your doctor, they're on p.21 of the Bloodwork Cheat Sheet.
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Which test on the calendar have you been putting off? Hit reply and tell us. We read every one.
Wednesday Preview
Wednesday is the other half of the story: the full-body scans, executive check-ups and 50-cancer blood tests that feel like extra peace of mind, and what happens to the people who have them.
Until Wednesday.
Longevity Daily / The Building Decades
P.S. Know someone who's turned 45 and never sent the bowel kit back? Forward them this. The Bloodwork Cheat Sheet has the blood tests to add while they're at it.