14 Screening Tests to Consider After 50

3. Colorectal cancer screening

A full colonoscopy may not be necessary for everyone, depending on your risk for colorectal cancer. Other screening options — such as at-home stool tests — may be appropriate, Spotts says. Each test has its own screening schedule, so it’s worth discussing the options with your doctor.

• Ages 45 to 75: The USPSTF recommends screening starting at age 45 if you’re at average risk. Individuals at higher risk for colorectal cancer may need to be screened before age 45 and be screened more frequently.
• Ages 76 to 85: The USPSTF recommends screening selectively based on risk, medical history and discussions with your doctor.  

4. Hearing screening

Though the USPSTF doesn’t recommend screening for hearing loss if you don’t have any symptoms, other organizations do because about 1 in 3 people in the U.S. between 65 and 74 experience hearing loss.

• Age 50 and up: The American Academy of Otolaryngology–Head and Neck Surgery Foundation suggests screening starting at age 50. See a specialist for a type of hearing test called an audiogram if they find anything. If you have hearing loss or concerns about it, get a screening at least every three years. 

5. Vision screening

Even if you’ve never had vision problems, that doesn’t mean you should skip an eye exam.

• 40 and up: The American Academy of Ophthalmology (AAO) recommends seeing an eye care professional for an eye disease screening starting at age 40.
• Over age 65: You should have a complete eye exam with your ophthalmologist every year or two after this age, according to the AAO. 

6. Cervical cancer screening

Cervical cancer is most frequently diagnosed in women between the ages of 35 and 64, with the average age being 50, according to the ACS. Testing for it includes either a high-risk human papillomavirus (hrHPV) test or a pap smear test. The latter is less sensitive though more readily available.

Typically, doctors stop screening for cervical cancer at 65 in some women because it’s a very slow-growing cancer that wouldn’t be problematic during the woman’s lifetime, Rhodes says. However, research suggests some women may benefit from continued screening.

• Ages 30 to 65: For women at average risk, the Women’s Preventive Services Initiative recommendations, published this year in JAMA, call for a primary hrHPV test every five years or an hrHPV test and a pap smear every five years. They say to use a pap test every three years if hrHPV isn’t available. The hrHPV is an HPV test used in average-risk women that can detect HPV strains more likely to cause cervical cancer. Women who are at average risk shouldn’t receive screening more than once every three years. Your doctor can advise on a potentially different screening plan if you’re at a high risk.
• Over age 65: The USPSTF recommends against screening for cervical cancer if you’ve had regular screenings before and aren’t at high risk, though it’s always important to talk to your doctor before you stop this screening.
• If you’ve had a hysterectomy: The USPSTF recommends against screening for cervical cancer if you don’t have a history of a high-grade precancerous lesion or cervical cancer. 

7. Prostate cancer screening

Your doctor may suggest a prostate-specific antigen (PSA) test based on your family history and risk as early as 40 for men at high risk, according to the ACS.

If you’re over 50, your doctor may decide to do the test every year or every few years, Spotts says.

• Age 50: If you’re at an average risk for prostate cancer, this is the age at which you and your doctor should start to discuss screening, the ACS says.
• Ages 55 to 69: The USPSTF recommends periodic PSA screening based on shared decision-making with your doctor, according to the latest guidelines from 2018, which are being updated.
• Over 70: The USPSTF recommends against testing in men aged 70 or older, though this may change with revised guidelines. The ACS recommends that average-risk adults in good health with a life expectancy of more than 10 years continue screenings through age 75. Many men die with slow-growing prostate cancer — not because of it — so doctors don’t always recommend screening in this age group. That said, it could be warranted in some individuals.

Several organizations, such as the American Urological Association (AUA), use a life-expectancy-based approach rather than a strict age cutoff, says Dr. Bilal A. Siddiqui, a prostate cancer oncologist at the University of Texas MD Anderson Cancer Center. The AUA says screening should be based on a person’s preference, their age, risk, life expectancy and general health. So it’s reasonable to consider screening after age 70 in men who are in good health and have a life expectancy of more than 10 years, Siddiqui says.  

8. Osteoporosis screening

Clinicians use dual-energy X-ray absorptiometry (DEXA) scans to assess bone density and screen for osteoporosis, which affects about 1 in 5 women and 1 in 20 men over age 50.

• Ages 65 and up: The USPSTF recommends screening for all women 65 and up.
• Postmenopausal women under 65: The USPSTF suggests a DEXA scan for those who have a higher risk for fracture based on a risk assessment.  

9. Skin cancer screening

About 1 in 5 Americans will be diagnosed with skin cancer by the time they’re 70, the Skin Cancer Foundation reports. In fact, the deadliest form of skin cancer — melanoma — is found most often in people 65 to 74, according to the National Cancer Institute.

There aren’t formal guidelines for screening adults without symptoms, though your dermatologist can do a quick “skin check” at your routine appointment. The American Academy of Dermatology recommends you see a dermatologist if you notice anything suspicious on your skin. 

10. Abdominal aortic aneurysm screening

Men 65 to 75 who have smoked should have a one-time ultrasound for abdominal aortic aneurysm (AAA), which is more common in men, says Dr. Michael Silverstein, chair of the USPSTF. This simple ultrasound of your stomach area can identify an aneurysm before it becomes dangerous.

“For older men who have never smoked, screening may also be beneficial, depending on their individual circumstances,” Silverstein says. The USPSTF recommends against this screening in women who have never smoked and have no family history of AAA.

• Ages 65 to 75: The USPSTF recommends a one-time screening in men who have smoked. 
• Ages 65 to 75: Screen selectively in men who never smoked.

Screenings to expect from your primary care provider

Your doctor will likely check the following during your annual visit.

11. Blood pressure

Your doctor will measure your blood pressure to look at your risk of stroke and heart disease. Even if you check it at home, make sure you visit the doctor’s office at least once a year. Most people don’t show symptoms of high blood pressure, Sumego says, “so the office is the best place to get that measurement.” 

12. Blood work

Yearly blood work is also a smart idea, Sumego says. Your doctor will probably check your glucose level to better understand your risk for prediabetes and diabetes, which increases your cardiovascular disease risk, Sumego says.

If you’re over 65 and taking arthritis medications, make sure your doctor periodically measures your kidney function and blood count (to check for anemia), since they can be affected by some anti-inflammatory medications, Sumego says. 

13. Weight and body mass index (BMI)

These measurements can give your doctor more insight into your health and risks, especially since some conditions and diseases are linked to excess weight, such as diabetes, sleep apnea and high cholesterol, Sumego says.

Measuring your waist circumference isn’t generally standard, but some doctors may do it to assess your risk for diseases and conditions, as some research says it’s a better indicator than BMI. Knowing these can help you determine if you need to lose or gain weight, which goes a long way toward optimal health, she adds.

14. Lifestyle and social screenings

Your doctor can glean a lot by asking about your moods, alcohol or tobacco use, living situation, sexual health, hearing, vision, cognitive abilities and physical activity. Screenings for depression and anxiety are especially crucial, and doctors do it because those issues can be treated, Sumego says.  

“All of these things can then lead to social isolation, which we know increases the risk of medical conditions in the elderly particularly,” she notes.  

While cognitive screening isn’t standard in all older adults during primary care visits, Sumego may suggest a brief in-office screen based on talking with an individual.  

Your doctor also may ask if you feel safe where you’re living (and whom you’re living with, if anyone) and if you are dealing with any food insecurity, Spotts points out. The doctor may also ask about your diet and hydration levels, and about how many medications and supplements you take, Spotts says. 

If you’re sexually active or have a new partner, sexually transmitted infection (STI) screening is “reasonable,” Rhodes says, so be sure to ask about it if your doctor doesn’t bring it up. 

In addition to discussing screenings, make sure you talk with your doctor about vaccines because they can prevent illness too, Rhodes says. (See: 8 Vaccines You Need After 50 — and 1 to Consider.)