What an annual health check should and should not include
A useful annual check for a healthy adult covers a complete blood count, fasting glucose or HbA1c, a lipid profile, liver and kidney function, thyroid function, and a urine routine, with blood pressure and weight measured. Whole-body tumour marker panels and vitamin profiles for people without symptoms add cost and anxiety more often than information.
Health check packages compete on test count, because it is the easiest number to put on a hoarding. It is also the least useful one. A panel of eighty tests on a healthy thirty-year-old will produce three or four values outside the reference interval by chance alone, and each of those buys a follow-up test, a specialist visit and a fortnight of worry.
A sensible core, at any adult age
- Complete blood count
- Fasting glucose, or HbA1c if there is any family history of diabetes
- Lipid profile
- Liver and kidney function
- Thyroid function
- Urine routine
- Blood pressure, height and weight, measured rather than reported
That core catches the conditions that are common, silent in their early stages, and treatable — which is the actual test of whether screening is worth doing.
What to add, and when
| Stage | Worth adding | Why |
|---|---|---|
| Women over 40 | Mammography, per your doctor's advice | Breast cancer screening has evidence behind it |
| Anyone over 45 | An ECG, and a discussion about colorectal screening | Both catch things that are silent and treatable |
| Vegetarians, and anyone on long-term metformin | Vitamin B12 | Deficiency is genuinely common in both groups |
| Persistent tiredness, hair loss, or heavy periods | Iron studies and ferritin | The commonest reversible cause, and often missed |
What is usually being sold to you
Tumour marker panels in people without symptoms. CA-125, CEA and the rest were designed to monitor a known cancer, not to find one. Used as a screen in a healthy person they generate far more false alarms than diagnoses.
Whole-body scans for people with no symptoms, for the same reason plus a radiation dose.
Very wide vitamin panels. Vitamin D and B12 are worth checking in Indian adults. A ten-vitamin panel is not.
The part that is not a test
The measurement that predicts your next decade better than most of the panel is your blood pressure, and the intervention with the largest effect is usually not a prescription. A health check that hands you twenty numbers and no conversation has done the easy half of the job.
Ask whoever ordered the package what they would do differently depending on each result. Anything where the honest answer is "nothing" did not need doing.
Questions people ask
How often should a healthy adult have a check?
Once a year is reasonable for most adults over 30, and every two to three years below that unless there is a specific reason. More frequent testing in a healthy person mostly finds noise.
Are tumour markers useful for early cancer detection?
Not in people without symptoms. They were developed to monitor a diagnosed cancer, and used as a screen they produce a high rate of false positives that lead to invasive follow-up.
Should I get a vitamin D test every year?
If you were deficient and are on treatment, a recheck is sensible. If you were normal and nothing has changed, an annual repeat rarely changes anything.
This article is general information, not medical advice, and it is not a substitute for seeing a doctor. Reference intervals quoted here are typical adult ranges; your own report carries the interval that applied to your age and sex on the day your sample was drawn.