Introduction

The biggest health problems after 40 often do not announce themselves. You may feel completely fine while they are developing.

Blood pressure and blood sugar can rise, arteries can narrow, and bones can slowly lose strength, but you may feel fine. The goal is to catch these changes early, while there is still time to do something about them. Screening exists to detect those processes when they remain modifiable.

The check-ups below start with the ones most people should know about, then get to the ones that depend on an individual’s personal risk.

The Seven Health Checks

1. Bone Density (The Most Overlooked)

I am starting with your bones first for a reason, because it is the check-up almost everyone forgets. But this does not mean that everyone at or past 40 needs a bone-density scan.

Early menopause, long-term steroid use, low body weight, a previous fracture, or certain medical conditions can increase your risk. Weak bones are silent for years and usually do not hurt. For many people, the first sign is a fracture.

Think of it like the frame of a house. Everything can look perfectly fine from the outside while the structure beneath is slowly weakening. A DEXA scan helps pick that up before a fall or fracture does. It uses a very small amount of X-ray to measure bone density, especially at the hips and spine.

A hip or spine fracture in your 60s or 80s can cost you your independence. Longevity is not just about living longer. It is about staying strong enough to live on your own terms.

2. Blood Pressure

The simplest check-up on this list: a cuff and two minutes.

High blood pressure usually does not cause symptoms, but over years, it strains your heart, arteries, kidneys, and brain. Get it regularly checked, and know your numbers.

3. Blood Sugar (A1c)

Specifically, an A1c reflects your average blood sugar over about three months. Prediabetes and diabetes can develop for years and go undetected. A simple blood test can pick up changes early, when there is still time to make a meaningful difference.

The American Diabetes Association’s 2026 Standards of Care recommends screening from age 35, and at any age for adults with overweight or obesity who have at least one additional risk factor. By 40, you are already past the age at which screening is advised.

4. Colorectal Cancer Screening

Colorectal cancer has become the number one cause of cancer death in people under 50, which is one reason why screening now begins earlier than it did in the past.

The US Preventive Services Task Force (USPSTF) has recommended screening from age 45 for average-risk adults since 2021. A positive non-colonoscopy test needs follow-up with colonoscopy. People with a strong family history or other risk factors may need to start earlier.

5. Kidney Function

Kidney disease can progress without pain or noticeable changes in urination. Blood creatinine is used to estimate kidney filtration rate, while a urine albumin-to-creatinine ratio can detect early protein leakage.

This one is not for everyone; it matters most if you have diabetes, high blood pressure, or heart disease.

6. Sex-Specific Cancer Screening

For women, current USPSTF guidance recommends mammography every two years from age 40 to 74. Cervical screening with cytology, Human Papillomavirus (HPV) testing, or both follows separate age- and test-based intervals.

For men, Prostate Specific Antigen (PSA) screening is usually a shared decision rather than a routine one. The discussion may begin earlier at around age 50 for people at higher risk, including Black men and those with a strong family history.

7. Cholesterol Panel, Plus Lp(a)

This is the one I promised you, the single most important check on this whole list. A standard cholesterol panel usually consists of LDL, HDL, and triglycerides. In some people, additional markers such as ApoB and Lp(a) provide more information about cardiovascular risk.

Think of your bloodstream as a highway. Cholesterol is the cargo, and lipoproteins are the trucks carrying it. LDL tells you how much cholesterol is being carried, while ApoB tells you how many potentially harmful particles are on the road. More particles mean more chances for them to enter the artery wall and contribute to plaque.

Then there is Lp(a). This one is special because the level is mostly set by your genes.

About 1 in 5 people have elevated levels, and a standard cholesterol test would not pick it up. So even if your LDL looks fine, Lp(a) can reveal an inherited risk that would remain hidden, which is exactly why the American Heart Association now recommends every adult be tested at least once.

Conclusion

These checks are not all for everyone, or needed every year. The key is knowing your risks and checking the right things early.

You are not testing because you feel sick. You are testing so you never have to find out the hard way. Your doctor can help you figure out which tests you actually need.

Frequently Asked Questions

Are these necessary for someone who feels well?

Yes, that is the whole premise of screening. Several conditions can be present even when you feel completely well.

Do I need every test on this list?

No. Even though some check-ups are routine for most adults, cancer screening, kidney testing, bone density, sex-specific and colorectal screening depend on individual risk factors.

What are my options if I do not want a colonoscopy?

At-home options include an annual fecal immunochemical test (FIT) or stool DNA or RNA testing every three years. Blood-based screening is also available, but it is generally used when someone cannot complete the preferred test, as it is less sensitive for cancer and pre-cancerous changes.

Can Lp(a) be lowered through diet and exercise?

Usually not. It changes little with lifestyle. That is why, if your level is high, managing your other cardiovascular risk factors aggressively matters even more.

How often should I repeat these checks?

Screening frequency depends on age and individual risk. Blood pressure can be checked at most visits, cholesterol and A1c periodically, and cancer screenings on defined schedules. Lp(a) is generally a one-time test.

References

1. American Heart Association. (n.d.). Lipoprotein(a). Retrieved September 24, 2026, from https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/lipoprotein-a
2. Wilson, D. P., Jacobson, T. A., Jones, P. H., Koschinsky, M. L., McNeal, C. J., Nordestgaard, B. G., & Orringer, C. E. (2019). Use of Lipoprotein(a) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association. Journal of Clinical Lipidology, 13(3), 374–392. https://doi.org/10.1016/j.jacl.2019.04.010
3. U.S. Preventive Services Task Force. (2021, May 18). Colorectal cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
4. U.S. Preventive Services Task Force. (2024, April 30). Breast cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
5. American Diabetes Association. (n.d.). Diabetes Care. Retrieved September 24, 2026, from https://diabetesjournals.org/care
6. Koschinsky, M. L., Bajaj, A., Boffa, M. B., Dixon, D. L., Ferdinand, K. C., Gidding, S. S., Gill, E. A., Jacobson, T. A., Michos, E. D., Safarova, M. S., Soffer, D. E., Taub, P. R., Wilkinson, M. J., Wilson, D. P., & Ballantyne, C. M. (2024). A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. Journal of Clinical Lipidology, 18(3), S1933–2874(24)00033-3. https://doi.org/10.1016/j.jacl.2024.03.001
7. Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., de Ferranti, S. D., Gianos, E., Gluckman, T. J., Gradney, K. F., Isiadinso, I., Lloyd-Jones, D. M., Marrs, J. C., Martin, S. S., McLain, K. H., Mehta, L. S., … Wilkins, J. T. (2026). 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Journal of the American College of Cardiology, 87(19), 2624–2757. https://doi.org/10.1016/j.jacc.2025.11.016
8. Wolf, A. M. D., Hoffman, R. M., Walter, L. C., Zeigler-Johnson, C., Church, T. R., Guerra, C. E., Elkin, E. B., Etzioni, R., Herzig, A., Oeffinger, K. C., Perkins, R. B., Raoof, S., Tina Shih, Y. C., Skates, S. J., Kratzer, T. B., Manassaram-Baptiste, D., & Smith, R. A. (2026). Colorectal cancer screening: An update to the American Cancer Society guideline, 2026. CA: A Cancer Journal for Clinicians, 76(3). https://doi.org/10.3322/caac.70083
9. Siegel, R. L., Wagle, N. S., & Jemal, A. (2026). Leading cancer deaths in people younger than 50 years. JAMA, 335(7), 632–634. https://doi.org/10.1001/jama.2025.25467