For many people in the U.S., preventive care means getting an annual physical, getting a traditional blood work panel, and completing recommended cancer screenings. While these are important parts of staying healthy, they don’t always capture the full picture of your cardiovascular health, metabolic function, aerobic fitness, body composition, and other factors that can change gradually over time.
An executive health assessment can add another layer of context. Rather than replacing guideline-based preventive care, a comprehensive assessment can bring together your medical history, biomarkers, imaging when appropriate, sleep patterns, and other health data to identify your baseline risk for various chronic conditions and identify areas of your health that may warrant a closer look.
That said, the right time to begin preventive screenings depends on more than just your age. Your family history, genetics, symptoms, reproductive history, smoking history, and other individual risk factors may require you to start certain screenings well before that age. Your physician can recommend which screenings may be appropriate for you and the age you might want to consider starting them.
Health screenings adults over 40 may want to consider
As we explore health screenings to consider as you get older, it can be easy to feel weighed down by what seems like a never-ending to-do list. But aging is a privilege, and preventive care isn’t about finding more things to worry about. It’s about understanding what your body may need at each stage of life.
Not everyone over 40 needs the same preventive health screenings. While some recommendations are broadly based on age, other factors, including your sex, anatomy, family history, smoking history, body weight, medical conditions, medications, and previous test results, can help determine which screenings are appropriate for you and when.
As you continue to age, you may benefit from even more screenings, and that’s okay. Generally speaking, adults over 40 should discuss certain cancer screenings, cardiovascular risk factors such as blood pressure and cholesterol, metabolic health, and, when appropriate, bone health (especially if they’re at increased risk of osteoporosis) with their clinician.
Cancer screenings after 40
According to the National Cancer Institute, your risk for several cancers naturally increases steadily as you age, which is why several major cancer-screening recommendations begin or change around midlife. [1] These include:
Colorectal cancer screening
For adults who are considered average risk, the U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer screening beginning at age 45 and continuing through age 75. [2] Screening from ages 76 to 85 is more individualized based on factors such as your overall health, previous screening history, and personal preferences.
The American Cancer Society (ACS) follows similar guidance. Though, the organization does note that if you’re at increased risk due to factors such as a family history of colorectal cancer or inflammatory bowel disease, you may need to start screening earlier, undergo screening more frequently, or follow a different screening strategy. [3]
And screening doesn’t necessarily mean getting a colonoscopy every year. For adults at average risk who choose colonoscopy, it’s generally recommended every 10 years when results are normal. Other options include annual stool-based tests and CT colonography every five years, among others. Your physician can help determine which approaches and screening intervals are appropriate for you.
Breast and cervical cancer screening
For people with breasts who are considered at average risk for breast cancer, mammograms become an important part of your preventive care routine starting in your 40s. The USPSTF recommends getting a mammogram every two years from ages 40 through 74. [4]
But if you’re at an increased risk because of factors such as a strong family history, certain genetic variants, or previous breast findings, your physician may recommend starting earlier, screening more frequently, or adding other imaging.
Cervical cancer screening should also continue throughout your 40s and beyond. According to the ACS, the preferred option for people at average risk is a primary HPV test using a cervical sample collected by a healthcare provider every five years. Other options include a self-collected HPV test every three years, an HPV/Pap co-test every five years, or a Pap test alone every three years if HPV testing isn’t available until at least age 65. [5]
And even if you’ve received the HPV vaccine or aren’t currently sexually active, regular cervical cancer screening is still recommended. As with other preventive screenings, your personal medical history and previous results may affect which test you need and how often you need it.
Prostate cancer screening
When to begin prostate cancer screening depends in part on your individual risk. The ACS recommends that men at average risk discuss the potential benefits, risks, and uncertainties of screening with their physician starting at age 50. But that conversation should begin at age 45 for men at higher risk and at age 40 for those at even higher risk, including men with more than one first-degree relative who developed prostate cancer at an early age. [6]
Screening typically begins with a prostate-specific antigen (PSA) blood test. Depending on your PSA level and other risk factors, your physician can help determine whether additional testing is appropriate and how often you should be screened.
Lung cancer screening
Lung cancer screening is recommended for a more specific group of adults. The USPSTF recommends annual low-dose CT (LDCT) for adults ages 50 to 80 who have at least a 20 pack-year smoking history and currently smoke or quit within the past 15 years. [7]
If you have a history of smoking, knowing your cumulative exposure and when you quit can help your physician determine whether you qualify for annual lung cancer screening.
For some non-smoking individuals, lung cancer screening may also be considered. A history of occupational tobacco smoke or other second-hand smoke exposure, environmental radon gas exposure, family history, or carrying certain genetic variants may all influence personal risk and may be considered by your healthcare team.
Heart and metabolic screenings after 40
Unlike some cancer screenings, cardiovascular and metabolic screening doesn’t always come with a single milestone age range. Risk can begin developing gradually in young adulthood, making your 40s an important time to keep tabs on key biomarkers and make adjustments before those risks have opportunities to progress into disease.
Blood pressure and cholesterol screening
The USPSTF considers annual blood pressure screening a reasonable approach for adults 40 and older. If a reading suggests hypertension, your care team will likely recommend that you take at-home measurements throughout the day to confirm the diagnosis before treatment begins. [7]
Cholesterol screening can also help assess your cardiovascular risk. A standard lipid panel measures markers such as LDL cholesterol (the harmful kind) and triglycerides, while additional heart screening tests may provide more context. Apolipoprotein B (ApoB), for example, reflects the number of atherogenic lipoprotein particles, while lipoprotein(a), or Lp(a), can help identify inherited cardiovascular risk.
Diabetes and metabolic health screening
The USPSTF recommends screening for prediabetes and type 2 diabetes in asymptomatic adults ages 35 to 70 who are overweight or have obesity. Common screening tests include fasting blood glucose and HbA1c. [9]
Depending on your health history and risk factors, your physician may order a more comprehensive blood panel that covers even more metabolic markers.
When heart imaging adds context
Blood pressure and blood tests can help estimate cardiovascular risk, but they don't directly show what’s happening inside your coronary arteries.
For some people, imaging can add that information. CT coronary angiography (CTCA), for example, can visualize the coronary arteries and identify calcified and noncalcified plaque as well as any potential areas that have begun to narrow.
That doesn’t mean everyone over 40 needs a CTCA, but your age is one factor of several that help determine whether heart imaging could provide valuable information to your health.
Bone, muscle, and fitness after 40
Healthy aging isn’t only about avoiding disease. Maintaining muscle, bone, and cardiorespiratory fitness can help preserve mobility, independence, and functional fitness as you age.
A DEXA scan measures your bone mineral density (BMD) and can also provide information about your ratio of lean mass to fat mass. But getting a DEXA scan at 40 isn’t a universal guideline-based requirement. The USPSTF recommends osteoporosis screening for women 65 and older and for postmenopausal women younger than 65 who are at increased fracture risk due to lower estrogen levels. [10] For men, there isn’t currently enough evidence to recommend routine screening.
Cardiorespiratory fitness offers another useful baseline. VO2 max measures your body’s ability to take in and use oxygen during exercise, providing a measurable way to assess and track fitness as you age.
Sleep, cognition, and quality of life matter, too
Getting enough high-quality sleep each night is linked to longevity as it’s when your body heals, builds muscle, stores memories, and retains information. Poor sleep can affect how you feel and function day to day and is closely connected to your cardiovascular, metabolic, cognitive, and mental health.
If you think you have sleep apnea or another sleep disorder, testing can provide information that sleep duration alone cannot. At Biograph, at-home sleep testing can be used when clinically appropriate, while our broader sleep health assessment considers sleep alongside recovery and overall health.
Cognition deserves attention, too. Establishing a baseline can make it easier to recognize changes over time and consider them alongside factors such as cardiovascular health, metabolic risk, physical activity, sleep, and stress.
Not every adult over 40 needs a sleep study or extensive cognitive testing. But preventive health can tell us more when we look beyond whether annual lab results fall within a reference range.
What does an executive health assessment add after 40?
A traditional annual physical remains an important part of your preventive care routine. An executive health assessment can complement it by providing a more comprehensive view of your health and establishing a detailed baseline to track over time.
At Biograph, our comprehensive assessment brings together advanced blood work, cardiovascular evaluation, body composition, whole-body MRI, fitness testing, sleep assessment, and other diagnostics based on your health needs.
Staying consistent with these screenings is key as a normal result today doesn’t guarantee that risk won’t develop later. Comparing cardiovascular, metabolic, body-composition, fitness, and other health measures year over year can help identify changes and help inform a physician of the clinical (or holistic) interventions that may be working.
That's also why a second-year assessment shouldn’t simply repeat the first. Previous findings can help determine what deserves closer attention, what can be monitored, and how your preventive strategy should evolve.
Remember this: Turning 40 isn’t a medical event. But it can be a useful reminder to look beyond whether you're simply up to date on recommended screenings.
Commonly asked questions about screenings after 40
What tests should everyone over 40 get?
There’s no single group of medical tests that’s designated for every adult over 40. Blood pressure screening is broadly recommended, while cancer, metabolic, bone, and other screenings depend on age, sex, anatomy, family history, medical history, and individual risk factors. Talk to your care team about screenings and which might be most appropriate for you.
How often should adults over 40 get health screenings?
It depends on the screening. Some tests, such as blood pressure screenings, may be appropriate annually, while specific cancer screenings have their own intervals and eligibility criteria. Your previous results and individual risk may also change how frequently testing is recommended.
What cancer screenings are recommended after 40?
Depending on age and individual risk, screening may include mammography, cervical cancer screening, colorectal cancer screening, prostate cancer screening discussions, and, for eligible adults with a significant smoking history, annual low-dose CT for lung cancer. Screening may begin earlier for people at increased risk.
Should adults over 40 get a DEXA scan?
Not everyone over 40 needs a DEXA solely because of age. The USPSTF recommends osteoporosis screening for women 65 and older and for younger postmenopausal women at increased fracture risk. There aren’t currently recommendations for men in the same age group. A DEXA may also be used in other clinical contexts based on individual risk.
Is an executive health assessment worth it after 40?
An executive health assessment may provide useful additional context for people who want a more comprehensive baseline or whose medical history and risk factors warrant deeper evaluation. The number of tests done is often less important than whether those tests are clinically appropriate, interpreted alongside informed clinicians, and used to guide actionable changes.
Dr. Michael Doney is Biograph’s Executive Medical Director, with over 20 years of experience leading clinical care and advancing a more proactive, data-driven approach to medicine.
Clinical references
National Cancer Institute. Age and Cancer Risk. National Cancer Institute. May 2, 2025. Accessed September 17, 2026. https://www.cancer.gov/about-cancer/causes-prevention/risk/age
U.S. Preventive Services Task Force. Colorectal cancer: Screening. U.S. Preventive Services Task Force. May 18, 2021. Accessed September 17, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
American Cancer Society. Colorectal cancer guideline | how often to have screening tests. www.cancer.org. 2024. Accessed September 17, 2026. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html
U.S. Preventive Services Task Force. Breast cancer: Screening. U.S. Preventive Services Task Force. April 30, 2024. Accessed September 17, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
American Cancer Society. The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer. www.cancer.org. April 22, 2021. Accessed September 17, 2026. https://www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html
American Cancer Society. American cancer society recommendations for prostate cancer early detection. www.cancer.org. November 22, 2023. Accessed September 17, 2026. https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html
USPSTF. Lung Cancer: Screening. U.S. Preventive Services Task Force. March 9, 2021. Accessed September 17, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
USPSTF. Recommendation: Screening for hypertension in adults | United States Preventive Services Taskforce. www.uspreventiveservicestaskforce.org. April 27, 2021. Accessed September 17, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening
USPSTF. Recommendation: Screening for prediabetes and type 2 diabetes | united states preventive services taskforce. www.uspreventiveservicestaskforce.org. 2021. Accessed September 17, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes
USPSTF. Osteoporosis to Prevent Fractures: Screening. www.uspreventiveservicestaskforce.org. January 14, 2025. Accessed September 17, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening
