You know the list now. You've probably worked out which 1 or 2 you're missing. Here is what happens next: who you call, what it costs, and what to say when the receptionist asks why.
The gap is that people know they should test, but they put it off. In the bowel trial we quoted on Monday, 58% of the people invited never showed up. The test was free and posted to them.
Monday was which checks are worth having. Wednesday was which ones aren't. Today is the practical half: your own schedule on one page, men and women side by side, and how to get each test done where you live..
1. How to actually get each test
The route is different in each country, and knowing it in advance is most of the battle.
US. Anything on the Task Force's A or B list (bowel, breast, cervical, lung CT for smokers, the aortic scan, bone density, blood pressure, HbA1c for people carrying extra weight) is covered at no cost by most insurance plans when you're in the age band, because the Affordable Care Act ties coverage to that list. Ask the receptionist to book it as "preventive screening" so it's coded that way. ApoB and Lp(a) are the exceptions: your doctor can add them to a normal draw, or you can order them yourself through a direct-to-consumer lab.
UK. The NHS screening programs post the bowel kit from 50 and invite women for breast and cervical checks, and men at 65 for the aortic scan. The NHS Health Check covers blood pressure, cholesterol and diabetes risk every 5 years from 40 to 74; ask your doctor's office for it if you haven't been invited. ApoB and Lp(a) you'll usually need to pay for privately.
Australia. The bowel kit comes in the post every 2 years from 45 to 74, and you can request one at 45 to 49 if it hasn't arrived. BreastScreen invites women from 50 and accepts them from 40. A Medicare-funded Heart Health Check with your doctor from 45 covers blood pressure and cholesterol. Lp(a) is a request to your doctor or a direct pathology lab; the Lp(a) issue has the wording.
Everywhere. The eye exam is an optometrist, no referral. The hearing check is an audiologist. The skin check is a doctor or a skin clinic.
If the practice can't book it, ask who can. The answer is usually a direct lab, a pharmacy, or a screening program you can enroll in yourself.
2. What to say when the answer is no
Most readers who've written in about this hit the same wall: the doctor says it's not needed, and the conversation ends. These are the lines that keep it open.
"It's on the Task Force list for my age. Could you note in my file that I asked for it?" Said politely, this changes the conversation, because declining a guideline-backed screening now has to be written down.
"My father had it at 58, so I'd like to start at 48." Name the relative, the condition and the age. A specific family history is the most common reason a doctor will move a test earlier, and the most common thing people forget to mention.
"If you can't order ApoB and Lp(a), I'll get them done privately and bring the results back." Most doctors would rather order the test than have you turn up with a result they didn't request.
"What would you want to know before you'd order it?" For the calcium scan and PSA, where the guideline says it's a shared decision, this gets you the actual reasoning instead of a reflex no.
3. Set your own start age
The ages on the schedule are for someone with no family history. If a parent or sibling had bowel, breast or prostate cancer, melanoma, or broke a hip, the rule most guidelines use is to start 10 years before their age at diagnosis, or at the schedule age, whichever comes first. A mother with breast cancer at 45 means mammograms from 35. A father with bowel cancer at 52 means a colonoscopy at 42, and every 5 years rather than 10.
Two things that people miss. First, it counts on both sides: a father's prostate cancer matters to his daughters' breast risk through the same genes, and a mother's breast cancer matters to her sons. Second, you need the ages, not just the diagnoses. If you don't know them, this weekend is a good time to ask whoever in the family does.
Your Weekend Action
One job before Monday. Find your row on the schedule and book the one test on it you've never had.
If it's a program test (bowel, breast, cervical, aortic), check whether a kit or letter has already come and gone. Call the program and ask for another.
If it's a blood test (ApoB, Lp(a), HbA1c), add it to your next draw, or order it yourself. Lp(a) is the one to prioritize, because it only ever happens once.
If it's an appointment (eyes, hearing, skin, bone density, calcium scan), book it now for a date in the next month. The booking is the hard part, not the test.
Then write the date of your next one next to it. Most of these are every 1, 2 or 10 years, and nobody remembers that unaided.
The blood tests in the right words, and what to say if the first answer is no, are on p.21 of the Bloodwork Cheat Sheet.
The Week in Longevity
Five studies worth 30 seconds each.
01 · WALKING
4,067 British adults, average age 69, wore a wrist tracker for 9 days and did a timed walk. Over 12 years, 739 died.
Every extra 10 steps a minute in everyday walking went with about 17% lower risk of dying, close to what the clinic test showed. Three-quarters were men. Observational. Read the study →
02 · HEART
5,244 Norwegians were tracked from midlife. The group with high blood pressure, high cholesterol and extra weight throughout had hearts that read about 1.6 years older on an AI-read ECG.
They also had about twice the stroke risk of the stable low-risk group. The marker tracked the damage rather than causing it. Read the study →
03 · STRENGTH
108 women aged 40 to 77 did 12 weeks of supervised lifting, with or without cycling after, and were assigned 0.8, 1.6 or 2.2g of protein per kg a day.
Muscle gain was the same at all 3 protein levels. Adding the cycling cut body fat by about 2 percentage points and lifted fitness, at a small cost to leg strength. One trial, so not the last word on protein. Read the study →
04 · SLEEP
144 people with coronary artery disease and poor sleep were randomized to 12 weeks of Yoga Nidra, a lying-down guided relaxation, or sleep advice alone.
The meditation group slept about an hour longer and spent 82% of time in bed asleep, against 64%. Only 11% of participants were women, so read it as a men's result for now. No industry funding. Read the study →
05 · NUTRITION
6,025 Americans over 60 were followed for 12 years. Those in the top quarter for the main form of vitamin E had about 16% lower risk of dying overall and 35% lower risk of dying from cancer.
Blood levels, not supplements, and the big trials of vitamin E pills haven't shown this. Nuts, seeds and olive oil are where it comes from in food. Read the study →
Which test did you book this weekend? Hit reply and tell us. We read every one.
Monday Preview
Monday we start a new deep dive. Until then, the screening schedule is saved above, and the one test is booked.
Until Monday.
Longevity Daily / The Building Decades
P.S. Know someone who's been putting off the same test for years? Forward them the schedule. The Bloodwork Cheat Sheet has the blood tests to add while they're at it. And tell us what you thought of this week in the poll below.