Screenings at 45
Forty-five is when colorectal cancer screening starts. The USPSTF lowered the age from 50 to 45 in 2021, and many older pages still say 50. (USPSTF, 2021)
Short answer: health checks at 45
- Colorectal cancer screening starts at 45 (grade B from 45 to 49, grade A from 50), with a stool test or colonoscopy. (USPSTF, 2021)
- Blood pressure every year. (USPSTF, 2021)
- Women: a mammogram every 2 years (40 to 74) and cervical screening, a Pap test every 3 years, an HPV test every 5 years, or both every 5 years (30 to 65). (USPSTF, 2024) (USPSTF, 2018)
- Blood sugar (prediabetes and type 2 diabetes) for adults 35 to 70 with overweight or obesity. (USPSTF, 2021)
- Blood tests: see the list below. Cholesterol for a heart risk estimate, blood sugar if you have overweight, hepatitis C once.
What changes at 45
- Colorectal cancer: screening starts at 45 (grade B until 49). Options run from a yearly stool test to a colonoscopy every 10 years. (USPSTF, 2021)
Blood tests at 45
Blood tests behind USPSTF advice at 45, 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 45: medicines and habits
Not screenings, but USPSTF-graded steps that can apply at 45. 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 45, ready to print.
Where 45 sits on the chart
Average-risk adults. Age ranges from the USPSTF. The line marks age 45.
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 45
| 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 |
| Colorectal cancer | 45 to 75 | Depends on the test: stool test every year, stool DNA-FIT every 1 to 3 years, CT colonography or flexible sigmoidoscopy every 5 years, colonoscopy every 10 years | B | USPSTF, 2021 |
| 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 45
| 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 |
| Colorectal cancer | 45 to 75 | Depends on the test: stool test every year, stool DNA-FIT every 1 to 3 years, CT colonography or flexible sigmoidoscopy every 5 years, colonoscopy every 10 years | 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, 40, 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 tests should I have at 45?
Under the USPSTF: colorectal cancer screening starts at 45, blood pressure is checked every year, and women continue mammograms every 2 years and cervical screening. Add blood sugar tests if you have overweight or obesity, a cholesterol test for the heart risk estimate behind statin advice, and a one-time hepatitis C test if never tested. (USPSTF, 2021) (USPSTF, 2021) (USPSTF, 2024) (USPSTF, 2018) (USPSTF, 2021) (USPSTF, 2022) (USPSTF, 2020)
What blood tests should I get at 45?
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)