Skip to content

Part 4 · Measure and monitor

Your prevention checklist

Every screening, test, vaccine, and habit worth doing at your age, on the schedule a serious prevention plan uses, with the guideline minimum alongside, the source, and the chapter that explains it.

1 min readEvidence reviewed Oct 25, 2026

How to use this list

Bring it to your yearly visit. Many items need only a request by name, and the source link next to each one shows the clinician where the recommendation comes from. Items marked with a condition, such as a smoking history or a strong family history, apply only to some people; the tag says who.

Optimal does not mean more of everything. Some tests appear here with a deliberate limit, and some popular ones are left off, because testing more often or more widely would bring more false alarms, radiation, or procedures than benefit. The chapter linked from each item explains where that line falls.

This list is a starting point, not a prescription. Your personal and family history can move many items earlier, make them more frequent, or take them off the list. Every item links to the chapter that explains it and to its source.

Show items for
Include

70 items for someone who is 40, plus 59 that depend on your history or risk.

Heart and blood vessels 14

  • Take a week of home readings (two each morning and evening) on a validated upper-arm cuff every 3 months, and readings most days while you adjust habits or medication; aim for an average under 120/80.

    Guideline minimum: USPSTF 2021: office check every 3 to 5 years at 18 to 39 with normal readings, yearly from 40 or at higher risk; confirm a diagnosis outside the clinic

    Guideline-backedModerateESH home monitoring position paper 2021Learn more

  • Get a lipid panel with ApoB every year from your 20s, and 4 to 12 weeks after starting or changing treatment until you reach your goal; aim for ApoB under about 60 mg/dL (LDL under about 70), lower with plaque or heart disease. Fasting is not required.

    Guideline minimum: ACC/AHA 2026: at 9 to 11 and at 19, then at least every 5 years; ApoB only in selected groups

    Guideline-backedModerateNLA 2024 expert consensus on ApoBLearn more

  • Measure Lp(a) once, ideally with your first adult lipid panel, and recheck only if it was near a threshold, after menopause, or with new kidney or thyroid disease; if it is 125 nmol/L (50 mg/dL) or higher, lower ApoB harder and ask close relatives to test.

    Guideline-backedModerateEAS consensus 2022Learn more

  • Discuss medication if ApoB stays above about 80 mg/dL by your late 30s or 40s despite 3 to 6 months of lifestyle change, if LDL is 160 or more at any age, or if you have plaque, high Lp(a), diabetes, or a high 30-year risk; then treat to your target.

    Guideline minimum: USPSTF 2022: statin at 40 to 75 with a risk factor and 10-year risk of 10% or more; ACC/AHA 2026 ties treatment to 10-year PREVENT risk

    Guideline-backedModerateFerence 2019, JAMA (lifelong LDL and blood pressure)Learn more

  • Each year, with your lipid panel, ask your clinician for your 10-year and 30-year PREVENT risk, and weigh the 30-year number and your risk enhancers when deciding on treatment.

    Guideline minimum: ACC/AHA 2026: calculate PREVENT risk to guide treatment, with thresholds based on 10-year risk

    Guideline-backedStrongACC/AHA 2026Learn more

  • Do not start daily aspirin for prevention on your own: for healthy people the bleeding risk outweighs the small benefit; if you already have heart disease, keep taking what was prescribed.

    Guideline-backedStrongUSPSTF 2022Learn more

  • Get a first calcium scan around 40 if you are not already on cholesterol-lowering treatment; any calcium means lower ApoB and LDL targets, and a zero can be rescanned in 3 to 7 years.

    Guideline minimum: ACC/AHA 2026: men 40 and older at borderline or intermediate 10-year risk, when the result would change the statin decision

    Guideline-backedModerateMenCARDIA, JAMA Cardiology 2017Learn more

  • Mention any change in erections at your yearly visit; new or worsening erectile dysfunction without an obvious cause calls for a full cardiovascular assessment, a sleep apnea check, and a testosterone workup if libido is also low.

    Guideline minimum: Princeton III consensus 2012: cardiovascular risk assessment for men with ED; no guideline asks about ED routinely

    Beyond guidelinesModerateMenMeta-analysis, Circulation: CQO 2013Learn more

If it applies to you

  • If you snore regularly, score three or more on STOP-Bang, or have high blood pressure, atrial fibrillation, or heart disease, get a home sleep apnea test even if you feel rested; retest after a weight change of about 10% or if symptoms return.

    Guideline minimum: USPSTF 2022: insufficient evidence to screen adults without symptoms; AASM: test when signs suggest sleep apnea; AHA 2021: screen with resistant hypertension or recurrent atrial fibrillation

    Guideline-backedWeakIf you snore, score 3+ on STOP-Bang, or have high blood pressure, atrial fibrillation, or heart diseaseAHA scientific statement 2021Learn more

  • If you are pregnant and at high risk of preeclampsia, for example after preeclampsia in a past pregnancy, with twins, or with chronic high blood pressure, diabetes from before pregnancy, kidney disease, or lupus, take 81 mg of aspirin a day from 12 weeks as your obstetric clinician directs.

    Guideline-backedStrongIf you are pregnant and at high risk of preeclampsiaWomenUSPSTF 2021 (grade B)Learn more

  • Tell every clinician about any preeclampsia, gestational hypertension or diabetes, delivery before 37 weeks, small baby, placental abruption, or pregnancy loss, and have it counted as a heart risk enhancer; after high blood pressure in pregnancy, take a week of home blood pressure readings every 3 months.

    Guideline minimum: ACC/AHA 2026: identify pregnancy complications as risk enhancers at the first visit; no set testing schedule

    Guideline-backedModerateIf you have been pregnantWomenAHA scientific statement 2021Learn more

  • Ask about genetic testing for familial hypercholesterolemia, and if it is confirmed, have your parents, siblings, and children tested.

    Beyond guidelinesModerateIf your LDL is 190 mg/dL or higher or close relatives had heart disease youngJACC expert panel 2018Learn more

  • Consider a coronary CT angiogram only if finding soft plaque would change your treatment, and agree in advance that plaque without symptoms means stronger prevention, not an automatic stent.

    Guideline minimum: No guideline recommends CT angiography for people without symptoms

    Beyond guidelinesWeakIf your calcium score is zero but you have a strong family history, familial hypercholesterolemia, very high Lp(a), or a long smoking historyMiami Heart Study 2022Learn more

  • Get your first calcium scan about five years early, from about 35 for men and 40 for women, so plaque can be treated before it grows.

    Guideline minimum: ACC/AHA 2026 recommends calcium scans only from 40 (men) and 45 (women)

    Beyond guidelinesModerateIf you have a strong family history of early heart disease, familial hypercholesterolemia, high Lp(a), diabetes, or a long smoking historySCCT expert consensus 2017Learn more

Cancer screening 12

  • Ask your clinician for a formal breast cancer risk assessment by 25 (family history, ancestry, and other factors) so that high-risk women can start MRI screening early.

    Guideline minimum: USPSTF 2024: not addressed for women without a family history

    Guideline-backedModerateWomenACR 2023Learn more

  • Get a first colonoscopy at 40 from an endoscopist with an adenoma detection rate of at least 35%, and repeat it every 5 years if normal (sooner if polyps are found). If you won't have a colonoscopy, do a yearly FIT or a stool DNA test every 3 years instead, and follow any positive result with a colonoscopy.

    Guideline minimum: USPSTF 2021 and ACS: from 45 to 75, colonoscopy every 10 years or a stool test every 1 to 3 years

    Guideline-backedModerateImperiale, NEJM 2008 (5-year rescreening yield)Learn more

  • Get a screening mammogram every year from 40, and keep going past 74 while you are in good health; read your report to see whether your breasts are dense.

    Guideline minimum: USPSTF 2024: every 2 years from 40 to 74

    Guideline-backedStrongWomenACR and Society of Breast Imaging 2021Learn more

  • Get a one-time clinical-grade multigene panel (at least BRCA1, BRCA2, PALB2, and the Lynch syndrome genes), ideally by 30, ordered through a clinician or genetic counselor, whatever your family history.

    Guideline minimum: USPSTF 2019: testing only for people whose personal or family history screens positive

    Beyond guidelinesModerateGuzauskas, Annals of Internal Medicine 2023Learn more

  • Know what your testicles normally feel like, check occasionally, such as in the shower, and see a doctor within a couple of weeks for a painless lump, swelling, heaviness, or dull ache.

    Guideline minimum: USPSTF 2011 (grade D): recommends against screening, including routine self-examination

    Beyond guidelinesWeakMenACS key statistics 2026Learn more

  • Not part of the optimal plan for average-risk adults. If you choose one anyway, do it only after the screening above, with a radiologist-led service, budget for follow-up of incidental findings, and treat it as a baseline rather than a yearly test.

    Guideline minimum: ACR 2023: insufficient evidence to recommend for people without symptoms or risk factors

    Beyond guidelinesWeakACR 2023 statementLearn more

If it applies to you

  • See a genetic counselor about testing if relatives had cancer young, several relatives had related cancers, or a relative carries a known variant such as BRCA or Lynch syndrome.

    Guideline-backedModerateIf you have a strong family history of cancer or a known family variantUSPSTF 2019Learn more

  • Get a liver ultrasound, with or without an AFP blood test, every 6 months.

    Guideline-backedModerateIf you have cirrhosis or high-risk chronic hepatitis BAASLD 2023Learn more

  • Get a breast MRI every year from 25 to 30, plus yearly mammography starting between 25 and 40 depending on the type of risk.

    Guideline-backedModerateIf you carry BRCA or a similar variant, have a lifetime risk of 20% or more, or had chest radiation when youngWomenACR 2023Learn more

  • Get a primary HPV test every 5 years from 25 to 65 (a self-collected HPV test every 3 years also works); testing more often adds tests and procedures without meaningful benefit.

    Guideline minimum: USPSTF 2018: Pap every 3 years from 21 to 29, then HPV every 5 years or Pap every 3 years to 65

    Guideline-backedStrongIf you have a cervixWomenACS December 2025Learn more

  • Start PSA testing at 40, then repeat on the schedule your result sets, with an MRI before any biopsy.

    Guideline minimum: USPSTF 2018: no screening before 55

    Guideline-backedModerateIf you are Black, carry a BRCA2 or other germline variant, or have a strong family history of prostate cancerMenAUA/SUO 2023Learn more

  • Add a yearly breast MRI to your mammogram, especially if your breasts are extremely dense; contrast-enhanced mammography or ultrasound is the fallback if you cannot have MRI.

    Guideline minimum: USPSTF 2024: evidence insufficient for supplemental screening

    Guideline-backedModerateIf your mammogram report says your breasts are denseWomenACR 2023Learn more

Metabolic health 7

  • Test HbA1c and fasting glucose every year from your 20s, and every 3 months while you change your diet, training, weight, or medication; aim for an HbA1c under about 5.5% and a fasting glucose in the 70s to mid-80s.

    Guideline minimum: ADA 2026: everyone from 35 (earlier with overweight plus a risk factor), at least every 3 years if normal, yearly with prediabetes; USPSTF 2021: every 3 years at 35 to 70 with overweight or obesity

    Guideline-backedModerateTabák 2009, Whitehall II (Lancet)Learn more

  • Ask your clinician to calculate FIB-4 from the liver enzymes and platelet count on your yearly labs, even if your liver tests are normal, and get a liver stiffness scan if it is 1.3 or higher. With prediabetes, diabetes, obesity, or two or more metabolic risk factors, this is standard care.

    Guideline minimum: AASLD 2023: every 1 to 2 years with prediabetes, type 2 diabetes, obesity, or two or more metabolic risk factors; no guideline screens people without them

    Guideline-backedModerateEASL–EASD–EASO 2024 MASLD guidelineLearn more

  • Measure your waist just above the belly button and divide by your height; keep it under 0.5.

    Beyond guidelinesModerateNICE NG246Learn more

  • Add fasting insulin to your yearly blood sugar tests (same lab each time) and calculate HOMA-IR and your triglyceride-to-HDL ratio; aim for a HOMA-IR under about 2 and a ratio well under 3.0.

    Beyond guidelinesWeakParcha 2022, NHANES (J Clin Endocrinol Metab)Learn more

  • Consider a 2-hour oral glucose tolerance test with glucose and insulin measured at 1 and 2 hours, as a baseline or when fasting results are borderline; a 1-hour glucose of 155 mg/dL or more is an early warning.

    Beyond guidelinesWeakPeter Attia, AMA #24 (2021)Learn more

If it applies to you

  • Get a 75-gram oral glucose tolerance test 4 to 12 weeks after delivery, then a diabetes test every year for life even if it is normal; with prediabetes, start intensive lifestyle change or metformin.

    Guideline minimum: ADA 2026: glucose tolerance test 4 to 12 weeks postpartum, then lifelong screening every 1 to 3 years

    Guideline-backedModerateIf you had gestational diabetesWomenADA Standards of Care 2026, section 15Learn more

  • Get a 75-gram glucose tolerance test at diagnosis and every 1 to 3 years, plus yearly blood pressure and ApoB, and screening for depression, anxiety, and sleep apnea if you snore.

    Guideline minimum: International PCOS guideline 2023: glucose status at diagnosis and every 1 to 3 years, lipids at diagnosis, blood pressure yearly

    Guideline-backedModerateIf you have PCOS (now also called PMOS)WomenInternational PCOS guideline 2023Learn more

Lab tests 6

  • Each year, add cystatin C to the creatinine-based eGFR on your metabolic panel and get a urine albumin-to-creatinine ratio; skip hard exercise for 24 hours before the urine test. With diabetes, high blood pressure, or heart disease this is standard care; for everyone else it is an inexpensive extra.

    Guideline minimum: ADA 2026: yearly with diabetes; KDIGO 2024 and the 2025 AHA/ACC blood pressure guideline: with high blood pressure, heart disease, past kidney injury, or a family history of kidney disease; no guideline tests people without risk factors

    Guideline-backedModerateShlipak 2013, NEJM; Cusick 2023, Annals of Internal MedicineLearn more

  • Check uric acid with your yearly labs and keep it under about 5.5 mg/dL through weight loss, little or no alcohol, and fewer sugary drinks; do not take urate-lowering drugs for it unless you have gout.

    Guideline minimum: ACR 2020: no screening; urate-lowering drugs only for gout

    Beyond guidelinesWeakVirdis 2020, URRAH (Hypertension)Learn more

  • Each year, get a comprehensive metabolic panel, a complete blood count, hs-CRP, and vitamin D (aim for about 30 to 50 ng/mL), drawn with the lipid, blood sugar, insulin, kidney, liver, and uric acid tests listed as their own items; repeat the relevant tests about every 3 months while you change a medication or major habit.

    Guideline minimum: No guideline recommends a routine yearly panel for healthy adults; the Endocrine Society advises against routine vitamin D testing

    Beyond guidelinesWeakACC scientific statement on inflammation 2025Learn more

If it applies to you

  • Check vitamin B12 every year from 50, or earlier if you take metformin or acid-reducing drugs long term or eat a vegan diet, because each lowers absorption or intake.

    Guideline minimum: ADA 2026: periodic B12 testing for people on metformin; AGA 2017 advises against routine checks for long-term acid-reducer users; no guideline for age alone

    Guideline-backedModerateIf you are 50 or older, take metformin or long-term acid reducers, or eat a vegan dietADA Standards of Care 2026, section 9Learn more

  • Check ferritin with iron and transferrin saturation every year; iron deficiency is common in these groups and often shows up before anemia does.

    Beyond guidelinesWeakIf you menstruate, have heavy bleeding, eat a vegetarian or vegan diet, donate blood, or train for enduranceWeyand 2023, JAMALearn more

  • Get a baseline semen analysis if you want children in the future, especially if you plan to wait into your late 30s or 40s, and before starting testosterone; consider banking sperm before testosterone or other treatments that affect fertility.

    Guideline minimum: AUA/ASRM 2021: semen analysis when a couple has trouble conceiving

    Beyond guidelinesWeakIf you may want children in the future or are considering testosteroneMenAUA/ASRM male infertility guideline 2021Learn more

Brain 2

  • Wear earplugs or earmuffs around noise above about 85 dBA, such as power tools, lawn mowers, concerts, and loud venues.

    Guideline-backedStrongNIOSH noise exposure limitLearn more

  • Consider learning your APOE genotype, with genetic counseling, after arranging any long-term care or life insurance you want; a carrier result is a reason to start prevention earlier and hold tighter targets.

    Guideline minimum: Not recommended by any guideline for people without symptoms

    Beyond guidelinesWeakREVEAL trial, NEJM 2009Learn more

Lungs and breathing 4

  • Consider one spirometry test around 40 even without symptoms or exposures, so a later decline is easy to spot. Repeat it in a year or two if it shows a low FEV1 with a normal ratio (PRISm), and do not start inhalers for a normal or borderline result.

    Guideline minimum: USPSTF 2022: recommends against screening adults without symptoms (grade D); GOLD 2026: screening spirometry not recommended without symptoms or exposures

    Beyond guidelinesWeakAgustí 2017, Lancet Respiratory MedicineLearn more

If it applies to you

  • Get a one-time blood test for alpha-1 antitrypsin level and genotype. A positive result means never smoking, avoiding dust, liver monitoring, testing your parents, siblings, and children, and, with emphysema, considering augmentation therapy.

    Guideline-backedModerateIf you have COPD, asthma that never fully clears, unexplained bronchiectasis or liver disease, or a relative with alpha-1 antitrypsin deficiencyAlpha-1 Foundation 2016 guidelineLearn more

  • Get spirometry before and after a bronchodilator if you have breathlessness, a lasting cough, wheeze, or repeated chest infections, or if you have ever smoked or vaped or spent years around dust, fumes, or smoke. Repeat it every 3 to 5 years while the exposure continues, and keep a copy of your FEV1 and FVC.

    Guideline minimum: GOLD 2026: spirometry for anyone with symptoms or risk factors, no set interval; USPSTF 2022: do not screen adults without symptoms (grade D)

    Guideline-backedModerateIf you have breathing symptoms, have ever smoked or vaped, or have had years of dust, fume, or smoke exposureGOLD 2026 reportLearn more

  • Review your asthma every year and after any flare-up: confirm your treatment includes an inhaled steroid rather than a reliever alone, check your inhaler technique, and update a written action plan. Needing your reliever more often is a reason to be seen sooner.

    Guideline-backedStrongIf you have asthmaGINA 2021 executive summaryLearn more

Digestive health 5

If it applies to you

  • Get one screening upper endoscopy, or a swallowed capsule sponge test, to look for Barrett's esophagus. If it is normal, it does not need repeating.

    Guideline-backedWeakIf you have chronic reflux symptoms plus 3 or more of: male sex, age over 50, White race, a smoking history, obesity, or a close relative with Barrett's esophagus or esophageal cancerACG 2022 Barrett's guidelineLearn more

  • Get a tissue transglutaminase IgA (tTG-IgA) blood test with total IgA while eating gluten in more than one meal a day for at least 6 weeks. Confirm a positive result with an endoscopy and biopsies before going gluten-free.

    Guideline minimum: ACG 2023: case finding in people with symptoms or risk factors, no mass screening; USPSTF 2017: insufficient evidence to screen people without symptoms

    Guideline-backedModerateIf a parent, sibling, or child has celiac disease, or you have unexplained iron, B12, or folate deficiency, low bone density, type 1 diabetes, autoimmune thyroid disease, raised liver enzymes, or IBS-type symptomsNICE NG20Learn more

  • Get a breath or stool test for H. pylori once. If it is positive, take a 14-day treatment course and retest afterward to confirm the infection is gone, and have household members tested.

    Guideline-backedModerateIf a parent, sibling, or child had stomach cancer, you were born in a region with high stomach cancer rates, someone in your household has H. pylori, or you have ulcers, ongoing indigestion, unexplained iron deficiency, or long-term aspirin or NSAID useChoi 2020, NEJMLearn more

  • Review the reason for your daily PPI with your doctor each year. Stay on it if you have Barrett's esophagus, severe esophagitis, a stricture, or a high risk of ulcer bleeding; otherwise try tapering or stopping, and expect a few weeks of rebound symptoms.

    Guideline-backedModerateIf you take a proton pump inhibitor (PPI) dailyAGA 2022 PPI de-prescribing updateLearn more

  • Ask a gastroenterologist about a screening upper endoscopy with biopsies, ideally at the same session as a colonoscopy. If it shows severe gastric atrophy or intestinal metaplasia, repeat it about every 3 years.

    Guideline minimum: AGA 2025: consider endoscopy for these groups, with no set starting age; no USPSTF recommendation

    Guideline-backedWeakIf a parent, sibling, or child had stomach cancer, you are a first-generation immigrant from a region with high stomach cancer rates, or you have a hereditary syndrome that raises stomach cancer riskAGA 2025 clinical practice updateLearn more

Muscle, bone, and mobility 3

  • Get a whole-body DEXA scan for lean mass, fat, and visceral fat in your 30s or 40s, then repeat it on the same machine; aim for appendicular lean mass in the top quarter for your age and sex and low, falling visceral fat.

    Guideline minimum: No guideline recommends body-composition scans for healthy adults

    Beyond guidelinesWeakPeter Attia, AMA #40 (2022)Learn more

  • Get a hip-and-spine DEXA in your 40s (women before or early in the menopause transition, men by 50), sooner with risk factors, then repeat on the schedule your result sets.

    Guideline minimum: USPSTF 2025: women from 65, or younger postmenopausal women at increased risk; BHOF 2022: men from 70, or 50–69 with risk factors; not routine for healthy premenopausal women or younger men

    Beyond guidelinesWeakBHOF clinician's guide 2022Learn more

If it applies to you

  • See a pelvic floor physical therapist after childbirth or at the first sign of urine leakage, pelvic pressure, or pain with sex, and keep up a pelvic floor muscle training program.

    Guideline minimum: ACP 2014: pelvic floor muscle training as first-line treatment once you have stress incontinence

    Guideline-backedStrongAfter childbirth, or if you leak urine or feel pelvic pressureWomenCochrane review 2018Learn more

Hormones 4

  • From your early to mid-40s, put menopause on your yearly visit agenda: symptoms, bone and heart risk, and whether hormone therapy or a non-hormonal treatment fits you. Hormone therapy's balance is most favorable before 60 or within 10 years of menopause; review it every year if you take it.

    Guideline minimum: The Menopause Society 2022: hormone therapy for bothersome symptoms or preventing bone loss under 60 or within 10 years of menopause; USPSTF 2022 recommends against it solely to prevent chronic conditions

    Guideline-backedStrongWomenThe Menopause Society 2022Learn more

  • Check TSH at about 35 and at least every five years after, or yearly with your blood work; test sooner with symptoms, a family history, plans for pregnancy, or an unexplained rise in LDL. Repeat an abnormal result before treating, and skip thyroid ultrasound unless a lump is found.

    Guideline minimum: USPSTF 2015: insufficient evidence to screen adults without symptoms; test when symptoms suggest thyroid disease

    Beyond guidelinesWeakAmerican Thyroid Association 2000Learn more

If it applies to you

  • If you have symptoms such as low libido, erectile problems, or loss of morning erections, get two fasting early-morning total testosterone tests, free testosterone if borderline, LH, FSH, a blood count, and PSA, and address sleep apnea and weight first. Do not take testosterone if your levels are normal.

    Guideline-backedModerateIf you have symptoms of low testosteroneMenEndocrine Society 2018Learn more

  • By your early 30s, talk through your timeline for children, cycle regularity, and whether egg freezing fits, ideally before 35 to 38; use an AMH test to plan egg freezing or IVF, not to judge your natural fertility.

    Guideline minimum: ACOG and ASRM: fertility evaluation after 6 months of trying over 35, and right away over 40; AMH not for predicting natural fertility

    Beyond guidelinesModerateIf you may want children in the futureWomenASRM committee opinion 2020Learn more

Eyes, ears, teeth, and skin 11

  • Brush for two minutes twice a day with fluoride toothpaste and clean between your teeth once a day with floss or interdental brushes.

    Guideline-backedStrongAmerican Dental AssociationLearn more

  • See a dentist for an exam and professional cleaning every 6 months; bitewing X-rays every 2 to 3 years are enough if you have no cavities and no increased risk.

    Guideline minimum: ADA: interval tailored to risk; a 2020 Cochrane review found risk-based intervals up to 24 months about as good for low-risk adults

    Guideline-backedWeakAmerican Dental AssociationLearn more

  • Use broad-spectrum SPF 30 or higher, a hat, and shade whenever the UV index is 3 or more, reapply every two hours outdoors, and never use tanning beds.

    Guideline-backedStrongAmerican Academy of DermatologyLearn more

  • Get a dilated baseline exam by 40 to check for glaucoma and other silent disease, then a comprehensive exam every 2 years, or every year with risk factors.

    Guideline minimum: AAO: baseline exam at 40, then as your eye doctor advises; USPSTF 2022: insufficient evidence for glaucoma screening

    Guideline-backedModerateAmerican Optometric AssociationLearn more

  • Look over your whole skin, including back and scalp (and palms, soles, and nails if you have darker skin), for spots that are new, changing, itching, or bleeding, using the ABCDE signs.

    Guideline minimum: USPSTF 2018: self-exam counseling unproven

    Beyond guidelinesWeakSkin Cancer FoundationLearn more

  • Get a baseline hearing test (audiogram) by 40, or earlier with years of noise exposure, then repeat it every 3 years and every year from 60 or once any loss appears; go sooner if you often ask people to repeat themselves.

    Guideline minimum: USPSTF 2021: insufficient evidence for hearing screening in adults 50 and older

    Beyond guidelinesWeakLancet Commission 2024 (hearing loss and dementia)Learn more

If it applies to you

  • Get a dilated retinal exam (or approved retinal photo screening) every year; every one to two years may be enough if you have no retinopathy and your glucose is at goal.

    Guideline-backedStrongIf you have diabetesADA Standards of Care 2026Learn more

  • Get maintenance cleanings every 3 to 4 months, lengthening the interval only once your periodontist or dentist says your gums are stable.

    Guideline minimum: EFP 2020: every 3 to 12 months, tailored to risk

    Guideline-backedWeakIf you have gum disease (periodontitis)EFP S3 guideline 2020Learn more

  • Ask your dermatologist whether nicotinamide 500 mg twice daily, the dose used in trials, makes sense for you; it lowered new non-melanoma skin cancers by 23% in a trial of high-risk people.

    Beyond guidelinesModerateIf you have had two or more basal or squamous cell skin cancersONTRAC trial, NEJM 2015Learn more

  • Get a full-skin exam by a dermatologist every year, starting in your 20s or 30s, or as your dermatologist advises.

    Guideline minimum: USPSTF 2023: its insufficient-evidence statement does not cover people with a personal or family history of skin cancer

    Beyond guidelinesModerateIf you have had skin cancer, have many or unusual moles, a family history of melanoma, fair skin with blistering sunburns, or weakened immunitySkin Cancer FoundationLearn more

  • Get a full-skin exam by a board-certified dermatologist every 2 years from 40 if you have light skin.

    Guideline minimum: USPSTF 2023: insufficient evidence for routine clinician skin exams

    Beyond guidelinesWeakIf you have light skinSkin Cancer Foundation (yearly exam advice)Learn more

Vaccines and infections 22

  • Get tested for HIV at least once, whatever your age, and again with each new partner or other exposure.

    Guideline minimum: USPSTF 2019: once from 15 to 65 (CDC: 13 to 64), repeated only with ongoing risk

    Guideline-backedStrongUSPSTF 2019, grade ALearn more

  • Get a one-time hepatitis B blood test (a three-part panel that also shows whether you need vaccination).

    Guideline minimum: USPSTF 2020: only adults at increased risk

    Guideline-backedModerateCDC 2023Learn more

  • Get at least one blood test for hepatitis C, whatever your age, and repeat it if you have ongoing risk; it is curable with a short course of pills.

    Guideline minimum: USPSTF 2020: once from 18 to 79 (CDC: all adults)

    Guideline-backedStrongCDC 2020Learn more

  • Get the updated COVID-19 vaccine each season; the FDA label covers adults under 65 only with a risk condition, so check coverage if you have none.

    Guideline-backedModerateAAFP 2026-2027 recommendationsLearn more

  • Get a flu vaccine every year, ideally in September or October.

    Guideline-backedStrongCDC adult schedule, 2025Learn more

  • Get Tdap once as an adult if you never had it, then a Td or Tdap booster every 10 years.

    Guideline-backedStrongCDC adult schedule, 2025Learn more

If it applies to you

  • Ask your clinician about preexposure prophylaxis, a daily pill or long-acting injection that prevents HIV.

    Guideline-backedStrongIf you are at increased risk of HIVUSPSTF 2023, grade ALearn more

  • Get a one-time blood or skin test for latent tuberculosis, and treatment if it is positive.

    Guideline-backedModerateIf you were born in or lived in a country where TB is common, or lived or worked in a homeless shelter or prisonUSPSTF 2023, grade BLearn more

  • Get tested for HIV, syphilis, chlamydia, and gonorrhea at least once a year, and every 3 to 6 months if you are at higher risk.

    Guideline-backedModerateIf you are a man who has sex with menMenCDC STI screening recommendationsLearn more

  • Get tested for syphilis if you are at increased risk.

    Guideline-backedStrongIf you are at increased riskUSPSTF 2022, grade ALearn more

  • Get Tdap during every pregnancy, preferably between weeks 27 and 36, to protect the newborn from whooping cough.

    Guideline-backedStrongIf you are pregnantWomenCDC adult schedule, 2025Learn more

  • Get two doses of varicella vaccine if you have never had chickenpox or its vaccine.

    Guideline-backedStrongIf born in 1980 or later with no evidence of immunityCDC adult schedule, 2025Learn more

  • Get two doses of hepatitis A vaccine (or a combined A and B series) unless your records or a blood test show you are immune.

    Guideline minimum: CDC 2025: recommended with risk factors such as travel, liver disease, HIV, or drug use, or for anyone who wants it

    Guideline-backedStrongIf you are not immuneCDC adult schedule, 2025Learn more

  • Complete a hepatitis B vaccine series if you have not had one.

    Guideline-backedStrongIf not already vaccinatedCDC adult schedule, 2025Learn more

  • Get meningococcal ACWY and B vaccines if you have a qualifying risk; adults 19 to 23 can also discuss MenB with their clinician.

    Guideline-backedStrongIf you have no working spleen, a complement disorder, take a complement inhibitor, or work with meningococcusCDC adult schedule, 2025Learn more

  • Get one or two doses of MMR unless you have a vaccine record or a blood test showing immunity.

    Guideline-backedStrongIf born in 1957 or later with no evidence of immunityCDC adult schedule, 2025Learn more

  • Get the two-dose mpox vaccine, 28 days apart, if you are at risk of exposure.

    Guideline-backedModerateIf you are at risk of mpox exposureCDC adult schedule, 2025Learn more

  • Get a pneumococcal conjugate vaccine before 50 if you have a qualifying condition.

    Guideline-backedStrongIf you have diabetes, chronic heart, lung, liver, or kidney disease, smoke, or have weakened immunityCDC adult schedule, 2025Learn more

  • Get two doses of Shingrix if disease or treatment has weakened your immune system.

    Guideline-backedStrongIf you have a weakened immune system, including HIVCDC adult schedule, 2025Learn more

  • Get tested for chlamydia and gonorrhea if you are at increased risk, for example with a new or multiple partners.

    Guideline-backedModerateIf you are at increased riskWomenUSPSTF 2021, grade BLearn more

  • Get the HPV vaccine series if you were not vaccinated and may have new sexual partners; it protects against the types you have not yet been exposed to.

    Guideline minimum: CDC 2025: shared clinical decision from 27 to 45

    Guideline-backedModerateIf not already vaccinated and you may have new partnersCDC adult schedule, 2025Learn more

  • Get tested for HIV, syphilis, chlamydia, and gonorrhea after any new sexual partner.

    Guideline minimum: USPSTF: chlamydia and gonorrhea for women 24 and younger or at increased risk; syphilis and HIV by risk; insufficient evidence for routine chlamydia testing in men

    Beyond guidelinesWeakIf you have a new sexual partnerCDC STI screening recommendationsLearn more

Mind 7

  • Fill out the GAD-7 anxiety questionnaire once a year alongside the PHQ-9, and more often during hard stretches; after 65, make sure a positive result leads to therapy first rather than sedatives.

    Guideline minimum: USPSTF 2023 (grade B): screen adults 19–64; insufficient evidence at 65 and older; no interval set

    Guideline-backedModerateUSPSTF 2023 (grade B)Learn more

  • Fill out the PHQ-9 depression questionnaire once a year, at your checkup or on your own; repeat it every 1–3 months during hard stretches such as pregnancy, bereavement, or job loss, and every few weeks during treatment.

    Guideline minimum: USPSTF 2023 (grade B): screen all adults; no interval set

    Guideline-backedModerateUSPSTF 2023 (grade B)Learn more

  • Learn CBT or mindfulness skills while you are well, through a workbook, app, group course, or a few therapy sessions; if you have had depression more than once, ask about an 8-week mindfulness-based cognitive therapy course.

    Guideline minimum: USPSTF 2019 (grade B): preventive counseling only for pregnant and postpartum people at higher risk

    Beyond guidelinesModerateCuijpers 2021 meta-analysisLearn more

  • Try ten minutes of mindfulness or five minutes of cyclic sighing most days, especially when stress or anxiety is high.

    Beyond guidelinesModerateGoyal 2014 meta-analysisLearn more

  • See friends or family in person at least weekly through a standing plan, keep a few people you could call in a crisis, and check loneliness once a year with the 3-item UCLA scale.

    Beyond guidelinesModerateFoster 2023, BMC Medicine (UK Biobank)Learn more

If it applies to you

  • If insomnia has lasted for months, start cognitive behavioral therapy for insomnia, with a therapist or an app, before sleeping pills.

    Guideline-backedStrongIf you have had trouble falling or staying asleep for monthsACP 2016 guidelineLearn more

  • If you care for a family member or friend, keep your own yearly checkup and mood checks, protect your sleep and exercise, and line up respite and support through your Area Agency on Aging (Eldercare Locator, 1-800-677-1116) before you are exhausted.

    Beyond guidelinesModerateIf you are a caregiver for a family member or friendREACH II caregiver trial, Annals of Internal Medicine 2006Learn more

Everyday habits 32

  • Aim for 7–9 hours of actual sleep (about 8–9 hours in bed), with bedtime and wake time within about 30 minutes every day, weekends included; check your real numbers with a tracker or diary for two weeks once or twice a year.

    Guideline minimum: AASM and SRS 2015: at least 7 hours a night for adults 18–60; no regularity target

    Guideline-backedModerateHuang 2020, JACC (MESA sleep regularity)Learn more

  • Build to 300–600 moderate-equivalent minutes a week, mostly easy zone 2 cardio (about 3–4 hours in three or four sessions); vigorous minutes count double, and one or two long days count as much as spreading it out.

    Guideline minimum: WHO 2020 and US Physical Activity Guidelines 2018: at least 150–300 minutes moderate or 75–150 minutes vigorous a week

    Guideline-backedStrongLee 2022, CirculationLearn more

  • Answer the three AUDIT-C questions about your drinking once a year, at your checkup or on your own, and ask for help cutting back if your score is high.

    Guideline minimum: USPSTF 2018 (grade B): screen adults at routine visits; no interval set

    Guideline-backedModerateUSPSTF 2018 (grade B)Learn more

  • Get up and walk for a few minutes every 30–60 minutes of sitting, and keep total sitting under about 10 hours a day; standing still is not a substitute.

    Guideline minimum: WHO 2020: sit less and replace sitting with activity of any intensity; no numeric limit

    Guideline-backedModerateAhmadi 2024, Int J EpidemiolLearn more

  • Avoid sugar-sweetened drinks, keep added sugar to 10 g or less per meal, and limit highly processed snacks, sweets, and processed meat.

    Guideline-backedModerateDietary Guidelines for Americans 2025–2030Learn more

  • Build up gradually to at least 30 g of fiber a day, more if your gut tolerates it, from beans, lentils, vegetables, whole fruit, whole grains, nuts, and seeds.

    Guideline minimum: Institute of Medicine adequate intake: 21 to 38 g a day, depending on age and sex

    Guideline-backedStrongReynolds 2019, LancetLearn more

  • Have at least two seafood meals (about 8 ounces) a week, mostly low-mercury fatty fish such as salmon, sardines, and trout.

    Guideline minimum: AHA 2018: one to two seafood meals a week

    Guideline-backedModerateFDA and EPA advice about eating fishLearn more

  • Eat about 1.6 g of protein per kilogram of body weight a day (0.73 g per pound) if you strength train, up to 2.2 g/kg if you like; 1.2–1.6 g/kg if you don't train or are over 65, with about 0.4 g/kg per meal after 65. Ask your doctor first if you have kidney disease.

    Guideline minimum: Dietary Guidelines 2025–2030: 1.2–1.6 g/kg a day; PROT-AGE and ESPEN: at least 1.0–1.2 g/kg after 65

    Guideline-backedModerateMorton 2018, British Journal of Sports MedicineLearn more

  • Aim for about 1,500 mg of sodium a day and stay under 2,300 mg unless you sweat heavily, and get potassium from vegetables, beans, and fruit; ask your doctor before using potassium salt substitutes.

    Guideline minimum: Dietary Guidelines 2025–2030: under 2,300 mg a day

    Guideline-backedStrong2025 AHA/ACC blood pressure guideline (review)Learn more

  • None is optimal for cancer, blood pressure, sleep, and heart rhythm; if you drink, keep it to 2 or fewer standard drinks a week, never more than 2 in a day, and never before driving.

    Guideline minimum: Dietary Guidelines for Americans 2025–2030: 'consume less alcohol'; no numeric limit

    Guideline-backedModerateCanada's Guidance on Alcohol and Health 2023Learn more

  • Test the lowest level of your home you regularly use, fix it if the result is 2.7 pCi/L (the WHO reference level) or higher, and retest every two years, after renovations, and after any mitigation.

    Guideline minimum: EPA: test all homes and fix at 4 pCi/L or higher; consider fixing from 2 pCi/L; no set retest interval

    Guideline-backedStrongWHO radon fact sheetLearn more

  • Buckle up in every seat on every trip, drive with zero alcohol and at or below the speed limit, never distracted or drowsy, and choose a car with automatic emergency braking.

    Guideline minimum: CDC: seat belt on every trip and never drive impaired; legal limit 0.08% blood alcohol (0.05% in Utah)

    Guideline-backedStrongCDC seat belt factsLearn more

  • Test smoke and CO alarms monthly, keep them near every sleeping area and on every level, and replace smoke alarms 10 years after manufacture.

    Guideline-backedModerateUS Fire AdministrationLearn more

  • Do three full-body sessions a week (at least two), covering squat, hinge, push, pull, and carry, reaching 10 or more hard sets per muscle group a week and adding load or reps over time.

    Guideline minimum: WHO 2020: muscle strengthening on 2 or more days a week, all major muscle groups

    Guideline-backedStrongACSM position stand 2026Learn more

  • See a primary care physician who practices prevention once a year to review your numbers against optimal targets, your family history, and the screenings and vaccines due. The free ACA preventive visit is the floor; book problems separately if cost matters.

    Guideline minimum: ACA: most private plans cover a yearly preventive visit and guideline screenings at no cost in network; Medicare covers a yearly wellness visit

    Guideline-backedModeratePereira Gray 2018 (continuity of care and mortality)Learn more

  • Aim for 7,000–10,000 steps on most days on top of your training; benefit levels off around 6,000–8,000 after 60 and 8,000–10,000 before 60.

    Beyond guidelinesModerateDing 2025, Lancet Public HealthLearn more

  • Name a healthcare proxy and complete your state's advance directive, give copies to your proxy and clinician, and review it after major life events.

    Beyond guidelinesModerateNational Institute on AgingLearn more

  • Run a properly sized HEPA purifier in your bedroom every night and in your main rooms on smoke days, and use a vented range hood whenever you cook with gas.

    Guideline minimum: EPA: air cleaners supplement source control and ventilation; no routine-use recommendation

    Beyond guidelinesModerateWalzer 2020, HypertensionLearn more

  • Keep an up-to-date list of every prescription, over-the-counter medicine, and supplement with doses, bring it to every visit and pharmacy, and ask a pharmacist to review it for interactions once a year.

    Beyond guidelinesModerateNational Institute on AgingLearn more

  • Record heart disease, cancer, diabetes, dementia, and other conditions in parents, siblings, children, and other relatives, with ages at diagnosis, and review it with your clinician at each yearly visit.

    Beyond guidelinesModerateMedlinePlus (NIH)Learn more

  • Once you have a few weeks of easy aerobic base, do one session of hard intervals such as the 4x4 (four 4-minute efforts at 90–95% of maximum heart rate) every week, and two during focused blocks.

    Beyond guidelinesModerateHelgerud 2007Learn more

  • Take a 10-minute walk, or break up sitting with short bouts of standing or movement, after your largest meal to blunt the glucose rise.

    Beyond guidelinesModerateBuffey 2022, Sports MedicineLearn more

  • Spend 5–10 minutes most days on balance work (one-leg stands, heel-to-toe walking, single-leg exercises, carries), starting in midlife; after 65, see the falls-prevention items.

    Beyond guidelinesWeakAraujo 2022, BJSMLearn more

  • Get a lab VO2 max test (cardiopulmonary exercise test) once a year, and every 3 months repeat a field fitness test plus grip, loaded carry, sit-rise, and one-leg-stand self-tests; aim for a VO2 max at or above the 90th percentile for your age and sex.

    Guideline minimum: No guideline recommends routine fitness testing; the AHA (2016) asks clinicians to assess fitness as a vital sign

    Beyond guidelinesWeakMandsager 2018, JAMA Netw OpenLearn more

If it applies to you

  • With a serious illness such as advanced cancer, heart failure, lung or kidney disease, or dementia, ask for specialist palliative care early, alongside your other treatment, and ask your clinician about a POLST form. Palliative care improves quality of life and symptoms; hospice is a separate choice for the last months of life.

    Guideline minimum: ASCO 2017: early palliative care for advanced cancer; other illnesses by clinician judgment

    Guideline-backedStrongIf you have a serious illness such as advanced cancer, heart failure, COPD, kidney failure, or dementiaASCO palliative care guideline 2017Learn more

  • Take a daily supplement with 0.4 to 0.8 mg (400 to 800 mcg) of folic acid whenever you could become pregnant, since neural tube defects form in the first weeks.

    Guideline-backedStrongIf you could become pregnantWomenUSPSTF 2023 (grade A)Learn more

  • If you have heart, metabolic, or kidney disease or symptoms such as chest pain or fainting, see a clinician before starting vigorous exercise or a maximal fitness test (or any exercise, if you are currently inactive).

    Guideline-backedWeakIf you have heart, metabolic, or kidney disease, or exercise symptomsACSM 2015Learn more

  • Test your well for total coliform bacteria, nitrates, total dissolved solids, and pH, plus any local contaminants your health department flags.

    Guideline-backedModerateIf you drink water from a private wellCDC well water guidelinesLearn more

  • Set a quit date and use both counseling (such as 1-800-QUIT-NOW) and medication such as varenicline or combination nicotine replacement; if you switch to e-cigarettes, switch completely and then aim to quit nicotine.

    Guideline-backedStrongIf you smoke or use other tobacco or nicotine productsUSPSTF 2021 (grade A)Learn more

  • Keep over-the-counter naloxone nasal spray where you can reach it, and learn the signs of an opioid overdose.

    Beyond guidelinesModerateIf anyone in your home takes opioids or you are around people who use drugsCDC naloxone FAQLearn more

  • Store firearms unloaded and locked, with ammunition locked separately, and consider storing them outside the home during a household crisis.

    Beyond guidelinesModerateIf there are firearms in your homeGrossman, JAMA 2005Learn more

  • Read your utility's annual water report, test your own tap for lead once (especially in a home built before 1986), and filter drinking and cooking water with an NSF/ANSI 53 or 58 filter certified for lead and PFOA/PFOS.

    Guideline minimum: EPA: utilities publish an annual report; home lead testing advised if concerned, with no set schedule

    Beyond guidelinesModerateIf you drink water from a public water systemEPA: lead in drinking waterLearn more