Screenings at 40
Forty is when routine mammograms start for women, after the USPSTF lowered the age from 50 in 2024, and when blood pressure checks become yearly for everyone. (USPSTF, 2024) (USPSTF, 2021)
Short answer: health checks at 40
- Women: mammograms start, every 2 years from 40 to 74 (the USPSTF lowered the start age from 50 in 2024). (USPSTF, 2024)
- Blood pressure every year from 40. (USPSTF, 2021)
- Women: cervical screening continues, a Pap test every 3 years, an HPV test every 5 years, or both every 5 years (30 to 65). (USPSTF, 2018)
- Not yet: colorectal screening starts at 45, lung CT at 50. (USPSTF, 2021) (USPSTF, 2021)
- Blood tests: see the list below. Cholesterol for a heart risk estimate from 40, blood sugar if you have overweight, hepatitis C once.
What changes at 40
- Breast cancer: a mammogram every 2 years, for women 40 to 74. (USPSTF, 2024)
- Blood pressure: every year from 40, instead of every 3 to 5 years. (USPSTF, 2021)
Blood tests at 40
Blood tests behind USPSTF advice at 40, each for the people the line names:
- Cholesterol (lipid panel): used in the 10-year heart risk estimate that decides whether a statin is advised at 40 to 75. (USPSTF, 2022)
- Blood sugar (fasting glucose or A1C): for adults 35 to 70 with overweight or obesity, every 3 years if normal. (USPSTF, 2021)
- Hepatitis C: once for adults 18 to 79, if never tested. (USPSTF, 2020)
- HIV: at least once up to 65, more often at increased risk. (USPSTF, 2019)
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 40: medicines and habits
Not screenings, but USPSTF-graded steps that can apply at 40. Each applies only to some people; the line says who.
- Statins for prevention: Adults 40 to 75 with a risk factor and a 10-year heart risk of 10% or more (grade B). 76 and older: evidence insufficient. (USPSTF, 2022)
- Daily aspirin: Do not start at 60 or older (grade D). At 40 to 59 with a 10-year heart risk of 10% or more: an individual decision (grade C). (USPSTF, 2022)
- 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)
- Medicines to lower breast cancer risk: Women 35+ at increased risk: offer tamoxifen, raloxifene or an aromatase inhibitor (grade B). Not at increased risk: do not use routinely (grade D). (USPSTF, 2019)
- 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 40, ready to print.
Where 40 sits on the chart
Average-risk adults. Age ranges from the USPSTF. The line marks age 40.
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 40
| Screening | Ages | How often | Grade | Source |
|---|---|---|---|---|
| Blood pressure | 18 and older | Every year | A | USPSTF, 2021 |
| Cervical cancer | 21 to 65 | Every 3 years (Pap) or 5 years (HPV or cotest) | A | USPSTF, 2018 |
| Prediabetes and type 2 diabetes Only if you have overweight or obesity | 35 to 70 | Every 3 years may be reasonable if results are normal | B | USPSTF, 2021 |
| Breast cancer | 40 to 74 | Every 2 years | B | USPSTF, 2024 |
| 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 40
| Screening | Ages | How often | Grade | Source |
|---|---|---|---|---|
| Blood pressure | 18 and older | Every year | A | USPSTF, 2021 |
| Prediabetes and type 2 diabetes Only if you have overweight or obesity | 35 to 70 | Every 3 years may be reasonable if results are normal | B | 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, 21, 25, 30, 35, 45, 50, 55, 60, 65, 70, 75, 80, 85, or the full chart (printable PDF). By sex: screenings for women over 40, screenings for men over 40. 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 40?
Under the USPSTF: a blood pressure check every year, and for women a mammogram every 2 years and cervical screening. From 40 a cholesterol test feeds the heart risk estimate behind statin advice. Add blood sugar tests if you have overweight, and a one-time hepatitis C test if never tested. Colorectal screening waits until 45 for people at average risk. (USPSTF, 2021) (USPSTF, 2024) (USPSTF, 2018) (USPSTF, 2022) (USPSTF, 2021) (USPSTF, 2020) (USPSTF, 2021)
What blood tests should I get at 40?
Cholesterol, for the heart risk estimate behind statin advice at 40 to 75; blood sugar every 3 years if you have overweight or obesity; hepatitis C once if never tested; and HIV at least once up to 65. A CBC, metabolic panel, thyroid or vitamin D test is not a routine USPSTF screening; your doctor may order one for a reason. (USPSTF, 2022) (USPSTF, 2021) (USPSTF, 2020) (USPSTF, 2019) (USPSTF, 2015) (USPSTF, 2021)