Turning 40? It's Time to Get Serious About Health Screenings

April 25, 2021

An adult woman is at the doctor's office and is getting good news after her check up

The oldest millennials celebrate a milestone as they officially enter their 40s this year. If you are among them, you’re also entering a time of life when health screenings become ever more important.

There is no one-size-fits-all rule when it comes to health screenings. Guidelines are aimed at the general population, so you should talk to your primary care doctor about when particular screenings are right for you. With that in mind, here’s advice from UH internal medicine specialist Babak Moini, MD, for the key screening exams for people age 40 and older and the recommended ages at which they should begin.

Breast Cancer Screening

The American College of Radiology and Society of Breast Imaging recommends women get a baseline (first) mammogram at age 40, regardless of their risk factors, followed by annual screening mammograms every year after.

A mammogram is a non-invasive X-ray that can detect breast cancer and other abnormalities. Mammograms can detect cancer early – when it’s most treatable – long before it can be felt. This improves the odds of survival and can help avoid more extensive treatment.

Colorectal Cancer Screening

The American Cancer Society recommends colorectal cancer screening starting at age 45 for men and women. The recommended age changed from 50 to 45 because studies show colorectal cancer rates on the rise among people under 50. Colorectal cancer is the second leading cause of cancer deaths in the United States.

A colonoscopy is considered the gold standard screening because in addition to its use in catching colorectal cancer early on when it is the most treatable, only a colonoscopy can prevent colorectal cancer before it develops by finding and removing pre-cancerous polyps. There are also at-home stool kits for those at average risk, however a positive test result will require a follow-up diagnostic colonoscopy.

Diabetes Screening

Starting at age 35, men and women should begin diabetes screening, especially if you are overweight or obese. Someone with multiple risk factors, such as family history, high blood pressure or high cholesterol, should start even earlier. Doctors use a simple blood sugar test to screen for diabetes.

Lung Cancer Screening

Lung cancer is the leading cause of cancer deaths in the United States. New lung cancer screening guidelines from the U.S. Preventive Services Task Force doubles the number of Americans who qualify for yearly low-dose CT scans of the lungs. The task force updated its guidelines to include people 50 and older who have a 20 pack-year smoking history, who smoke currently or who quit in the past 15 years.

A pack year is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. For example, a one-pack year is equal to smoking one pack per day for one year, or two packs per day for half a year, and so on.

Prostate Cancer Screening

Men should begin talking with their doctors about screening for prostate cancer at about age 45, says the National Comprehensive Cancer Network (NCCN).

The NCCN recommends an assessment that takes your risk factors into account, such as family medical history and race -- African-American men are at substantially higher risk of dying of prostate cancer -- as well a baseline prostate-specific antigen (PSA) level if appropriate.

If your PSA level is very high compared to others your age, or becomes higher when you enter your 50s, you are at greater risk of developing cancer, and of developing life-threatening cancer.

Men who have a higher risk of developing prostate cancer have more frequent screenings while men who are at lower risk would have them less frequently.

Other Screenings

Millennials have some time before they need to worry about osteoporosis screening. Bone density tests are recommended for women 65 and older, and for younger women who have been through menopause and are at increased risk for osteoporosis.

However, millennials who haven’t had their cholesterol checked are overdue. Cholesterol screening should begin at age 35 -- sooner for those with a strong family history or other risk factors such as obesity or smoking.

Along the same lines, cervical cancer screening is recommended for women starting at age 21 with regular Pap tests. Women ages 30 to 65 have the option of getting a pap test combined with a HPV test. If results are normal, the test is done every five years.