Preventive Health Screenings: What to Get and When

What counts as a preventive health screening?

A preventive screening is a test done on someone without symptoms, aimed at catching a disease — or a risk factor for one — before it causes problems. This is different from diagnostic testing, which happens after symptoms appear or a condition is already suspected.

In the United States, the main body that reviews evidence for these tests is the U.S. Preventive Services Task Force (USPSTF), an independent panel of volunteer experts formed in 1984. The USPSTF grades each recommendation from A to D based on the strength of the evidence, and services graded A or B are the ones with the strongest support — high or moderate certainty that the benefit is substantial.

Why the letter grade actually matters

A Grade A recommendation means the USPSTF has high certainty the service provides substantial benefit, and the guidance is to offer it. A Grade B recommendation means high certainty of moderate benefit, or moderate certainty of moderate-to-substantial benefit — still a clear "offer this" recommendation, just with slightly less certainty behind it.

This grading system matters beyond the doctor's office. Under U.S. law, most private insurance plans are required to cover A and B graded preventive services at no cost to the patient — no copay, no deductible. In 2025, a Supreme Court ruling (Kennedy v. Braidwood) preserved this zero-cost access for an estimated 150 million+ Americans, after the requirement had faced a legal challenge.

Screenings recommended in adulthood, by general age range

These reflect current USPSTF A/B recommendations for adults at average risk; individual risk factors — family history, smoking status, or other conditions — can shift what's appropriate for a specific person, which is why these are starting points for a conversation with your doctor, not a personal prescription.

In your 20s and 30s: Blood pressure screening, cervical cancer screening (starting at 21), and screening for sexually transmitted infections based on risk factors are generally recommended. Depression screening is recommended across adulthood, not just in these decades.

In your 40s: Colorectal cancer screening now starts at age 45 for average-risk adults, a change from the previous threshold of 50, reflecting rising colorectal cancer rates in younger adults. Breast cancer screening (mammography) recommendations generally begin in this decade as well, with specifics depending on the guideline source.

In your 50s and 60s: Lung cancer screening with low-dose CT is recommended for adults aged 50 to 80 who have a significant smoking history — specifically at least 20 pack-years — and who currently smoke or quit within the past 15 years. Cholesterol and lipid screening is also standard for this age group.

65 and older: A one-time abdominal ultrasound to screen for abdominal aortic aneurysm is recommended for men aged 65 to 75 who have ever smoked. Osteoporosis screening with a DEXA scan is recommended for all women aged 65 and older. Fall-prevention exercise programs are recommended for community-dwelling older adults at increased fall risk.

What's new in preventive screening guidelines

Preventive care guidelines aren't static, and a few recent changes are worth knowing about. In January 2026, the Health Resources and Services Administration (HRSA) announced updated cervical cancer screening guidance offering women aged 30 to 65 at average risk the option to self-collect samples for HPV testing, rather than requiring a clinician-collected sample — a change intended to reduce a real barrier to screening for some women. This option is set to take effect for insurance plan years starting in 2027.

Breast cancer screening coverage has also expanded recently, with HRSA broadening no-cost coverage to include follow-up imaging after an initial mammogram, not just the first screening test. Combined with the Supreme Court's 2025 ruling preserving no-cost coverage for A and B graded services generally, the overall direction has been toward wider access rather than narrower.

Screenings aren't one-size-fits-all

The age ranges above describe average-risk adults — but risk factors can shift the recommended starting age or frequency meaningfully. A strong family history of colorectal or breast cancer, for example, often means starting screening earlier than the general guideline suggests. Smoking history, personal history of certain conditions, and even some medications can also change what's appropriate.

This is exactly why "when should I get screened" is a conversation to have directly with a doctor who knows your history, rather than a question with one universal answer. A screening schedule built for the general population is a reasonable starting point, not a substitute for that conversation.

Beyond cancer and heart disease: mental health and vaccines

Preventive care extends beyond the physical screenings people usually think of first. Depression screening is recommended for all adults, regardless of age, and is often folded into a routine primary care visit through a brief questionnaire rather than a separate appointment. Screening for unhealthy alcohol use and offering brief behavioral counseling when appropriate is also part of the standard preventive package for adults.

Immunizations function as a form of preventive care too, even though they aren't "screenings" in the traditional sense. For adults 65 and older, current recommendations generally include annual influenza and COVID-19 vaccination, pneumococcal vaccination, the shingles vaccine (Shingrix), and RSV vaccination — each targeting a disease that becomes more dangerous with age. Staying current on these is often reviewed at the same visit where other preventive screenings get discussed, which makes an annual wellness visit a useful anchor point for preventive care generally.

Why some people skip screenings — and why that's worth addressing directly

Cost, time, discomfort, and simply not knowing a screening is recommended are among the most common reasons people delay or skip preventive care, according to research cited by public health agencies. The expansion of no-cost coverage for A and B graded services is aimed squarely at the cost barrier, but the other barriers — discomfort with certain tests, or uncertainty about what's actually recommended for your age and risk profile — often require a direct conversation with a provider to resolve.

The newer HPV self-collection option for cervical cancer screening is a good example of a guideline change built specifically around removing a non-financial barrier: some women avoid screening because of the clinician-collected sample process itself, not because of cost, and self-collection is designed to address that directly.

FAQ

What does it mean if a screening has a USPSTF Grade A or B? It means the USPSTF has high or moderate certainty that the service provides substantial benefit for the recommended population. Under U.S. law, most private insurance plans must cover Grade A and B services at no cost to the patient.

At what age should colorectal cancer screening start? The USPSTF currently recommends colorectal cancer screening starting at age 45 for adults at average risk, a change from the earlier recommended starting age of 50, reflecting rising rates of colorectal cancer in younger adults.

Who should get lung cancer screening? Adults aged 50 to 80 who have at least a 20 pack-year smoking history and currently smoke, or quit within the past 15 years, are recommended for annual low-dose CT lung cancer screening under current USPSTF guidance.

Is there a new option for cervical cancer screening? Yes. As of a January 2026 HRSA announcement, women aged 30 to 65 at average risk have the option to self-collect samples for HPV testing rather than requiring a clinician-collected sample, though this option is set to take effect for insurance plans starting in 2027.

Do preventive screenings cost anything with insurance? Most U.S. private insurance plans are required to cover USPSTF Grade A and B preventive services at no out-of-pocket cost. A 2025 Supreme Court ruling preserved this requirement after it faced a legal challenge.

Takeaway

The most useful thing you can do with a preventive care guide like this one is bring it to your next appointment and ask which of these apply to you specifically — your age, family history, and personal risk factors are what actually determine your screening schedule, not a generic chart.

5. Sources

• U.S. Preventive Services Task Force (USPSTF) — A and B Recommendations

• Health Resources and Services Administration (HRSA) — Women's Preventive Services Guidelines, cervical and breast cancer screening updates (January 2026)

• California Department of Public Health (CDPH) — USPSTF Recommendations summary

• Northwestern University Institute for Medical Quality and Innovation — "USPSTF – Recent Updates to Cancer Screening Recommendations"