Screenings at 21
Twenty-one is when cervical cancer screening starts: a Pap test every 3 years until 29. The rest of the list for adults in their early 20s is short and mostly done once. (USPSTF, 2018)
Short answer: health checks at 21
- Women: cervical screening starts at 21, a Pap test every 3 years until 29 (the 2018 final USPSTF statement; an update is in progress). (USPSTF, 2018)
- Sexually active women 24 and younger: chlamydia and gonorrhea screening. (USPSTF, 2021)
- Blood pressure every 3 to 5 years if your readings are normal and you have no added risk; every year if you are at higher risk. (USPSTF, 2021)
- Screening questions for depression, anxiety, unhealthy alcohol use and drug use, at a regular visit. (USPSTF, 2023) (USPSTF, 2023) (USPSTF, 2018) (USPSTF, 2020)
- Infections: HIV and hepatitis C at least once; syphilis and hepatitis B if you are at increased risk. (USPSTF, 2019) (USPSTF, 2020) (USPSTF, 2022) (USPSTF, 2020)
What changes at 21
- Cervical cancer: a Pap test every 3 years for women 21 to 29. (USPSTF, 2018)
- Chlamydia and gonorrhea: screening for sexually active women 24 and younger; one test checks for both. (USPSTF, 2021)
- Blood pressure: from 18, every 3 to 5 years if readings are normal and there is no added risk; every year if at increased risk. (USPSTF, 2021)
- HIV: at least once for everyone 15 to 65, more often for people at increased risk. (USPSTF, 2019)
- Hepatitis C: once for adults 18 to 79, if not tested before. (USPSTF, 2020)
- Depression and anxiety: screening for adults, with no set interval. (USPSTF, 2023)
Blood tests at 21
Blood tests behind USPSTF advice at 21, each for the people the line names:
- Hepatitis C: once for adults 18 to 79, if never tested. (USPSTF, 2020)
- HIV: at least once from 15 to 65, more often at increased risk. (USPSTF, 2019)
- Syphilis and hepatitis B: for people at increased risk. (USPSTF, 2022) (USPSTF, 2020)
- Blood sugar: routine screening starts at 35 for adults with overweight or obesity; clinicians should consider earlier screening for some people, such as those with a family history of diabetes. (USPSTF, 2021)
- Cholesterol: the USPSTF statin advice, which uses a cholesterol test, starts at 40. (USPSTF, 2022)
Not routine screening tests:
- A complete blood count (CBC) and a basic or comprehensive metabolic panel are not on the USPSTF list of recommended (A and B) services for adults without symptoms. (USPSTF, A and B list)
- Thyroid tests: the USPSTF found the evidence insufficient to recommend for or against screening adults without symptoms. (USPSTF, 2015)
- Vitamin D: the same, evidence insufficient for adults without symptoms. (USPSTF, 2021)
Your doctor may still order any of these for symptoms, medicines or a known condition. Ranges for the numbers: know your numbers. All ages in one table: blood tests by age.
Prevention at 21: medicines and habits
Not screenings, but USPSTF-graded steps that can apply at 21. Each applies only to some people; the line says who.
- Folic acid before pregnancy: Anyone who could become pregnant: a daily supplement with 0.4 to 0.8 mg (400 to 800 mcg) of folic acid (grade A). (USPSTF, 2023)
- PrEP to prevent HIV: Teens and adults at increased risk of HIV, weighing at least 35 kg (77 lb): PrEP medicine to lower the risk (grade A). (USPSTF, 2023)
- Quitting smoking: Adults: counseling plus FDA-approved medicines (grade A). Pregnancy: counseling (A); medicines and e-cigarettes, evidence insufficient (I). Free help: 1-800-QUIT-NOW. (USPSTF, 2021) (Smokefree.gov)
- Healthy eating and activity counseling: Adults with heart risk factors: counseling on diet and activity (grade B). Without risk factors: case by case (grade C). (USPSTF, 2020) (USPSTF, 2022)
- Weight-loss programs, BMI 30+: Adults with a BMI of 30 or higher: offer or refer to an intensive weight-loss program built on diet and activity (grade B). (USPSTF, 2018)
Before the visit: questions to ask your doctor about screening at 21, ready to print.
Where 21 sits on the chart
Average-risk adults. Age ranges from the USPSTF. The line marks age 21.
Swipe sideways to see ages 18 to 85
- Blood pressure : ages 18 and older
- Cervical cancer (women) : ages 21 to 65
- Prediabetes and type 2 diabetes, if a risk factor applies : ages 35 to 70, if you have overweight or obesity
- Breast cancer (women) : ages 40 to 74
- Colorectal cancer : ages 45 to 75
- Lung cancer, if a risk factor applies : ages 50 to 80, if you have a 20 pack-year history and smoke now or quit within 15 years
- Osteoporosis (women) : ages 65 and older
- Abdominal aortic aneurysm (men), if a risk factor applies : ages 65 to 75, if you have ever smoked
- Hepatitis C : ages 18 to 79
- HIV : ages 18 to 65
- Depression : ages 18 and older
- Anxiety : ages 18 to 64
- Unhealthy alcohol use : ages 18 and older
- Unhealthy drug use : ages 18 and older
- BRCA risk assessment (women), if a risk factor applies : ages 18 and older, if you or your family have had breast, ovarian, tubal or peritoneal cancer
- Chlamydia and gonorrhea (women), if a risk factor applies : ages 18 to 24, if you are sexually active
- Syphilis, if a risk factor applies : ages 18 and older, if you are at increased risk (for example HIV or another STI, men who have sex with men, drug use, or past incarceration)
- Hepatitis B, if a risk factor applies : ages 18 and older, if you are at increased risk (for example born where hepatitis B is common, HIV, injection drug use, or a household or sex partner with hepatitis B)
- Latent tuberculosis, if a risk factor applies : ages 18 and older, if you are at increased risk (born in or lived in a country where TB is common, or lived in a shelter or correctional facility)
Bars show the age range each recommendation covers, not how often to test. Open-ended ranges run to the edge of the chart. Tap a bar for the interval, test options and the USPSTF source.
Women at 21
| Screening | Ages | How often | Grade | Source |
|---|---|---|---|---|
| Blood pressure | 18 and older | Every 3 to 5 years if normal and not at increased risk; yearly if at risk | A | USPSTF, 2021 |
| Cervical cancer | 21 to 65 | Every 3 years (Pap) | A | USPSTF, 2018 |
| Osteoporosis (before 65) Only if you are past menopause and at increased risk | 18 to 64 | Not set by the USPSTF; evidence on repeat intervals is limited | B | USPSTF, 2025 |
| Hepatitis C | 18 to 79 | Once for most adults; repeat if risk continues (for example, injection drug use) | B | USPSTF, 2020 |
| HIV | 18 to 65 | At least once; repeat testing is reasonable for people at increased risk | A | USPSTF, 2019 |
| Depression | 18 and older | No set interval; screen if not screened before, then use clinical judgment | B | USPSTF, 2023 |
| Anxiety | 18 to 64 | No set interval | B | USPSTF, 2023 |
| Unhealthy alcohol use | 18 and older | No set interval | B | USPSTF, 2018 |
| Unhealthy drug use | 18 and older | No set interval | B | USPSTF, 2020 |
| BRCA risk assessment Only if you or your family have had breast, ovarian, tubal or peritoneal cancer | 18 and older | Once, with genetic counseling if the risk tool is positive | B | USPSTF, 2019 |
Men at 21
| Screening | Ages | How often | Grade | Source |
|---|---|---|---|---|
| Blood pressure | 18 and older | Every 3 to 5 years if normal and not at increased risk; yearly if at risk | A | USPSTF, 2021 |
| Hepatitis C | 18 to 79 | Once for most adults; repeat if risk continues (for example, injection drug use) | B | USPSTF, 2020 |
| HIV | 18 to 65 | At least once; repeat testing is reasonable for people at increased risk | A | USPSTF, 2019 |
| Depression | 18 and older | No set interval; screen if not screened before, then use clinical judgment | B | USPSTF, 2023 |
| Anxiety | 18 to 64 | No set interval | B | USPSTF, 2023 |
| Unhealthy alcohol use | 18 and older | No set interval | B | USPSTF, 2018 |
| Unhealthy drug use | 18 and older | No set interval | B | USPSTF, 2020 |
Rows marked "Only if" apply when that risk factor is true for you. Other ages: 18, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, or the full chart (printable PDF). How often each test repeats: screening intervals chart. Cost: which screenings insurance and Medicare cover.
Questions people ask
What health checks should I have at 21?
Under the USPSTF: women start cervical screening with a Pap test every 3 years, and sexually active women 24 and younger are screened for chlamydia and gonorrhea. Everyone gets a blood pressure check every 3 to 5 years if normal, screening questions for depression, anxiety, alcohol and drug use, and HIV and hepatitis C tests at least once. (USPSTF, 2018) (USPSTF, 2021) (USPSTF, 2021) (USPSTF, 2023) (USPSTF, 2023) (USPSTF, 2018) (USPSTF, 2020) (USPSTF, 2019) (USPSTF, 2020)
What blood tests should I get at 21?
Hepatitis C once and HIV at least once if never tested; syphilis and hepatitis B if you are at increased risk. Routine blood sugar screening starts at 35 if you have overweight, sooner for some people, and the statin advice that uses a cholesterol test starts at 40. A CBC, metabolic panel, thyroid or vitamin D test is not a routine USPSTF screening; your doctor may order one for a reason. (USPSTF, 2020) (USPSTF, 2019) (USPSTF, 2022) (USPSTF, 2020) (USPSTF, 2021) (USPSTF, 2022) (USPSTF, 2015) (USPSTF, 2021)