Preventive Care

Health Screenings You Need in Your 20s and 30s

You are never too young to start preparing for a healthy future. While it’s important for people of all ages to take an interest in their care, establishing a good relationship with a primary care physician as a young adult can have many positive effects as you grow older.

“Preventative medicine is something I think is really important,” explains Nadia Javaid, MD, a family practitioner with Saint Agnes Medical Center in Fresno, California. “The more we can screen for and diagnose health problems before they progress, the better we can treat people and the more we can educate people.”

As part of this, it’s vital to understand what health issues you should be regularly screened for and why. We spoke with Dr. Javaid about screenings to expect in our 20s and 30s—and how they can set us up for good health in the long-term.

Wellness Visits

No matter how old you are, taking charge of your health means a regular wellness visit. It is here that your doctor will assess your overall health—including height, weight and BMI—and help you understand any health risks in the coming months and years.

“This visit should include obtaining your vitals such as your heart rate and blood pressure,” adds Dr. Javaid. “It is also important for your doctor to ask you how you are eating and sleeping, if you’re consuming alcohol and how you are feeling. Your mental health should definitely be part of the conversation.”

It’s during this visit you may also receive any needed immunizations. Guidelines recommend that both men and women get a flu shot every year. If you received the tetanus-diphtheria and acellular pertussis (Tdap) immunization before age 19, you should get a tetanus-diphtheria (Td) booster every 10 years. (If you didn’t, ask your doctor about a new series of vaccines.) Should you need additional immunizations, such as the measles, mumps and rubella (MMR) vaccine, your doctor will advise based on your job, lifestyle, vacation plans, health status and age.

Your doctor may also check your skin for signs of cancer during these visits, especially if you’re at higher risk—you’ve had skin cancer already, it runs in the family or you’re exposed to a lot of sun. Both the American Cancer Society (ACS) and the American Academy of Dermatology suggest regular self-exams of the skin, so you can identify changes over time.

Screenings for Sexually Transmitted Infections

If you are sexually active, it is recommended that you get screenings and immunizations for certain infectious diseases.

“Often people, especially men, don’t have symptoms with many of these sexually transmitted diseases,” explains Dr. Javaid. “That is how it can be passed on from partner to partner. There are actually studies that show chlamydia is highest among women who are 20 to 24 years old, and it can ultimately cause infertility if not treated.”

Your screenings may depend on lifestyle and risk factors assessed by your physician, though Dr. Javaid suggests being tested for common infections, for peace of mind. Official recommendations include the following:

  • The US Preventive Services Task Force (USPSTF) suggests sexually active women age 24 and under be screened for chlamydia and gonorrhea. The Centers for Disease Control and Prevention (CDC) suggests age 25 and under. Older women with risk factors, including a new partner, should be screened, as well.
  • The CDC notes that adults at a higher risk for infection, including men who have sex with men (MSM), should be screened for chlamydia, gonorrhea and syphilis annually. The USPSTF suggests screenings should be based on risk.
  • The USPSTF recommends everyone between ages 15 and 65 be tested for HIV. The CDC notes that some MSM benefit from additional tests every three to six months, and anyone who shares needles or doesn’t practice safe sex should get a yearly screening.
  • Pregnant women should be screened for syphilis, hepatitis B and HIV. At-risk pregnant women should also be screened for chlamydia and gonorrhea early in their pregnancy with repeat testing as needed.

The American Society for Colposcopy and Cervical Pathology also recommends women between 21 and 29 receive a Pap smear every three years. Those between 30 and 65 should receive an HPV test/Pap smear every five years.

“If a Pap smear is abnormal, then patients may need more regular testing and might need a Pap smear every year,” concludes Dr. Javaid. “The Pap smear screens for cervical cancer, which can have symptoms of irregular vaginal bleeding, bleeding after intercourse and pelvic pain. If you experience any of these symptoms, notify your doctor as you may need to be screened early.”

Blood Pressure Screenings

More than 100 million US adults are considered to have hypertension, also known as high blood pressure. Even though the condition is comparatively uncommon in younger adults, Dr. Javaid says there has been a bit of a rise due to the obesity epidemic.

Hypertension typically doesn’t have any symptoms—and is often called “the silent killer” as a result. “High blood pressure can lead to heart failure and kidney failure,” stresses Dr. Javaid. “It can also increase your risk of stroke and heart attack. That’s why it’s really important to treat this disease.”

The USPSTF guidelines state that healthy men and women in this age group should start blood pressure screenings at the age of 18. The American Heart Association (AHA) recommends you screen every two years beginning at 20. If you have health conditions such as diabetes or heart disease, or if you have higher-than-normal blood pressure (over 120 mm Hg systolic or over 80 mm Hg diastolic), you will likely need to get it checked more often, which could range from every 3 to 12 months.

Cholesterol Screenings

In addition to monitoring your blood pressure, another way to help prevent heart disease is through regular cholesterol screenings. Even if you feel completely healthy, high cholesterol has no symptoms, so understanding the risks is key.

“As we age, the risk of high cholesterol increases,” states Dr. Javaid. “High blood pressure, diabetes, smoking, obesity and a sedentary lifestyle all influence your risk of having high cholesterol.”

Together, the American College of Cardiology and American Heart Association (ACC/AHA) recommend cholesterol blood tests begin at age 20 and are repeated every four to six years. People at higher risk—like those with obesity—may start earlier and be screened more frequently. Your total cholesterol should be below 200mg/dL.

When it comes to diabetes screenings, keeping track of your test results can alert you and your doctor to changes over time. Try the glucose tracker on Sharecare for iOS and Android, where you can record your levels.

Diabetes Screenings

The American Diabetes Association estimates that more than 9 percent of Americans have diabetes. “Uncontrolled diabetes can cause kidney failure and blindness,” says Dr. Javaid. “It definitely increases your risk of heart attack and stroke. It can also result in increased yeast infections in females and, for males, it can contribute to erectile dysfunction.”

While there are no strict guidelines about diabetes screening for people in their 20s and 30s without risk factors, it’s recommended for those with certain risk factors including obesity, high blood pressure, sedentary lifestyle, family history or being part of a high-risk ethnic group. These groups include African, Asian and Mexican Americans as well as Native Hawaiians and Pacific Islanders. You may have the option of one of three blood tests, including an oral glucose tolerance test, which lets your physician know how you process glucose.

Dental Exams

The National Institute of Dental and Craniofacial Research (NIDCR) has found that more than 90 percent of adults over the age of 20 have tooth decay—part of why it’s vital to get regular dental exams and cleanings from a young age. In addition to brushing and flossing, cleanings can help prevent gum disease and plaque buildup, and maintain the integrity of tooth enamel to prevent decay.

It’s recommended that both men and women get an exam and cleaning once or twice a year, as specified by your dentist. Depending on your exam, you may be instructed to be seen more frequently.

Eye Exams

It’s less likely you’ll experience vision problems in your 20s and 30s, than when you are older. However, you should still have your eyes examined regularly as a preventative measure. That’s why the American Optometric Association recommends that you get an eye exam every two years between ages 19 and 40.

These recommendations change if you already have glasses or if you have health complications such as high blood pressure or diabetes. In that case, both men and women should be prepared for additional visits—likely at least once per year.

Dr. Javaid does advise that certain populations visit the ophthalmologist every year as some medications—especially those that treat rheumatoid arthritis and some other autoimmune diseases—can affect the eyes.

Additional Testing For Men and Women

In addition to the previously discussed exams, women in their 20s and 30s should also be aware of the following screenings:

  • Pap smear, as noted previously, is recommended every three years from ages 21 through 29. Between 30 and 65, it can be spaced out to every five years, and should include an HPV test (a new option is to get the HPV test alone, without the Pap). Pelvic exams are more controversial; certain groups recommend against them, while others suggest having them periodically. It’s best to discuss these with your doctor.
  • Mammograms are rarely recommended in this age group unless you have high-risk factors, like the BRCA1 or BRCA2 gene mutation. In these cases, the ACS suggests beginning yearly mammograms at age 30, though you should always speak with your doctor. Otherwise, most expert guidelines suggest you be given the option to begin between ages 40 and 50.
  • Rather than have breast self-exams, the ACS and the American College of Obstetricians and Gynecologists (ACOG) recommend women familiarize themselves with the feel of their own breast tissue, so you’re able to detect changes. ACOG says clinical exams can be offered every one to three years between ages 25 and 39.

Men between ages 20 and 39 are not advised to receive prostate or testicular cancer screenings, though some organizations recommend that men with certain risk factors be screened via self-examination.

Sourcing: CDC, U.S. National Library of Medicine, U.S. Preventive Services Task Force, The American College of Gynecologists, American Heart Association, World Health Organization, UptoDate , American Diabetes Association, American Optometric Association

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