While we cannot change our genetics or prevent every health condition, modern medicine has made early detection through screenings both possible and powerful. These tools can identify potential issues before symptoms appear, when treatment is often most effective.
When to Start and How Often:
| Procedure | When to Start* | How Often to Test* |
| Colonoscopy | 45 years old (average risk) | Every 10 years until age 75 |
| Mammogram | 45 years old (average risk)
40-44 years old (optional) |
Yearly or every 2 years |
| Pap Smear | 21 years old | Every 3 years through age 65
(continue after age 65 if high risk and/or new sexual partner) HPV testing- repeat every 5 years starting at age 30 |
| Skin Check | ~20 years old | Yearly |
| DXA | 65 years old (women)
75 years old (men) |
Every 2 years |
*Note: individuals considered at high risk may need to be screened earlier and/or more frequently
Colonoscopies
Colonoscopies have significantly transformed how we detect and prevent colorectal cancer, a condition that ranks as the third most diagnosed cancer in the United States1. One of the major challenges associated with this malignancy is its often asymptomatic progression during early stages, underscoring the critical need for routine screening. Colonoscopy enables healthcare providers to examine the colonic and rectal mucosa. During this procedure, physicians can not only identify but also excise polyps, small mucosal growths that may evolve into malignant tumors2.
The American Cancer Society recommends initiating screening for adults at average risk at age 45, with subsequent procedures typically advised every ten years until age 75; thereafter, continuation largely hinges on individual health status and preferences3. For those with a family history of colorectal cancer or certain genetic syndromes, earlier and more frequent screenings (i.e., one to three years) may be warranted3.
Mammograms
Mammography is one of the most effective tools for detecting early breast cancer4. This specialized x-ray can identify subtle abnormalities in breast tissue that may not be palpable during a physical examination4.
As with any preventive screening, timing depends on your personal health profile. For women at average risk, regular mammograms are usually recommended starting at age 454, with the option to start earlier for those between 40 and 44. Women 55 years and older may continue with yearly screenings or biennial screenings, if preferred4.
Those at higher risk due to factors like a strong family history of breast cancer or carrying the BRCA1 or BRCA2 gene, doctors typically advocate for beginning earlier and screening more frequently4. In these cases, an individualized screening plan is the best approach.
Pap Smears
Pap smears (aka pap tests) are essential for detecting cervical cancer by identifying abnormal cells on the cervix, many of which are linked to strains of the human papillomavirus (HPV), a common virus that can sometimes lead to cancer5.
Typically, women should begin pap testing at age 21 and continue every three years through age 655. Starting at age 30, it may be combined with HPV testing, which only needs to be repeated every five years and provides a more comprehensive assessment of cervical health5.
Healthcare providers may recommend more frequent screenings for women with a history of abnormal results, previous HPV infections, or compromised immunity5. Additionally, pap smears may remain necessary after age 65 for those at higher risk, particularly if there is a new sexual partner or a history of sexually transmitted infections.
Skin Checks
As the body’s largest organ6, the skin is highly vulnerable to cancer. Non-melanoma types, such as basal cell carcinoma and squamous cell carcinoma, are the most prevalent, while melanoma, though less common, is more aggressive and carries a greater risk of metastasis7. Early detection is essential, as it significantly improves the chances of successful treatment and achieving long-term remission.
The American Academy of Dermatology recommends that adults regularly monitor their skin for any changes8. This includes often-overlooked areas, such as the scalp, back, and soles of the feet. Familiarity with the skin’s normal appearance enables individuals to detect new moles or alterations in the size, shape, color, or texture of existing spots.
In addition to self-examinations, an annual full-body skin check by a dermatologist is strongly advised, especially for those with fair skin, a family history of skin cancer, frequent sun exposure, or a history of blistering sunburns. During these exams, dermatologists examine the skin for suspicious moles, lesions, or other growths that may suggest cancerous or precancerous changes. If abnormalities are identified, dermatologists may perform a biopsy to determine whether further treatment is necessary.
DXA (Bone Density)
A DXA scan measures bone mineral density (BMD), which helps detect osteoporosis and its precursor, osteopenia. Osteoporosis is a condition marked by decreased BMD and the deterioration of bone tissue, which significantly increases the risk of fractures, particularly in the hips, spine, and wrists9. As we age, preserving bone strength becomes essential for reducing fracture risk and supporting long-term mobility and independence.
Bone density screening is typically recommended every two years for women starting at age 65 and for men at age 70; however, certain populations may need to be screened earlier and more frequently10. Risk factors include having a family history of osteoporosis, low body weight, lack of regular strength training, insufficient calcium or vitamin D intake, certain medications, a history of fractures, and conditions like eating disorders that affect skeletal integrity10. Additionally, post-menopausal women are at increased risk due to a decline in estrogen levels, as this hormone is implicated in maintaining bone density11.
If a DXA scan reveals low BMD, physicians will recommend preventive measures such as dietary modifications, increased physical activity, and, when appropriate, medication. Registered dietitians can also offer targeted nutritional guidance to support bone health and help prevent further loss.
Key Takeaways
There is no one size fits all approach to health screenings. The timing and type of tests depend on factors such as age, sex, medical history, and lifestyle. That is why understanding personal risk factors and working closely with a physician to develop a tailored screening plan is essential.
Most importantly, staying proactive matters. If something feels off, speak up. After all, it is impossible to treat what has not been identified; that is exactly what screenings are meant to uncover.
References
- American Cancer Society. Colorectal Cancer Statistics | How Common Is Colorectal Cancer? www.cancer.org. Published January 13, 2023. Accessed April 24, 2025. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html
- American Cancer Society. What is Colonoscopy? | How is a Colonoscopy Done? www.cancer.org. Published February 16, 2024. Accessed April 24, 2025. https://www.cancer.org/cancer/diagnosis-staging/tests/endoscopy/colonoscopy.html
- American Cancer Society. Colorectal Cancer Guideline | How Often to Have Screening Tests. www.cancer.org. Published January 29, 2024. Accessed April 24, 2025. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html
- American Cancer Society. ACS Breast Cancer Screening Guidelines. www.cancer.org. Published December 19, 2023. Accessed April 24, 2025. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
- Mayo Clinic. Pap Smear. Mayoclinic.org. Published July 20, 2024. Accessed April 24, 2025. https://www.mayoclinic.org/tests-procedures/pap-smear/about/pac-20394841
- Yousef H, Alhajj M, Sharma S. Anatomy, Skin (Integument), Epidermis. PubMed. Published June 8, 2024. Accessed April 24, 2025. https://www.ncbi.nlm.nih.gov/books/NBK470464/
- American Academy of Dermatology Association. Types of Skin Cancer. www.aad.org. Published 2024. Accessed April 24, 2025. https://www.aad.org/public/diseases/skin-cancer/types/common
- American Academy of Dermatology Association. Detect Skin Cancer: How to Perform a Skin Self-Exam. Aad.org. Published 2020. Accessed April 24, 2025. https://www.aad.org/public/diseases/skin-cancer/find/check-skin
- International Osteoporosis Foundation. About Osteoporosis | International Osteoporosis Foundation. www.osteoporosis.foundation. Published 2023. Accessed April 24, 2025. https://www.osteoporosis.foundation/patients/about-osteoporosis
- Cleveland Clinic. DEXA Scan (DXA): Bone Density Test, What Is It & How It’s Done. Cleveland Clinic. Published 2020. Accessed April 24, 2025. https://my.clevelandclinic.org/health/diagnostics/10683-dexa-dxa-scan-bone-density-test
- NHS . Bone Density Scan (DEXA scan). NHS. Published 2019. Accessed April 24, 2025. https://www.nhs.uk/conditions/dexa-scan/why-its-done/
