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- If you’re in your 20s, it’s important to get some health screening tests.
- Everyone in this age group should get screened for high cholesterol, high blood pressure, and HIV, experts say.
- Those with certain risk factors may need screenings for diabetes, skin cancer, and the STDs gonorrhea and chlamydia.
- People with a cervix start should start getting a Pap smear – a test that screens for cervical cancer – starting at age 21.
Twenty-somethings may be inclined to put off doctor’s appointments and health tests until they’re older, but there are some screenings they shouldn’t wait to get.
This is especially true when it comes to tests for “silent” conditions that can damage health without causing any symptoms, like high blood pressure and certain sexually transmitted infections.
INSIDER asked Dr. Robert Segal, a cardiologist and co-founder of LabFinder, an online service that helps patients find and make appointments for medical tests, about which screenings are most important before you hit age 30.
Remember that you may need different or more frequent testing based on your own medical history and family history, so it’s always best to consult with your doctor for personalized advice. But, in general, there are a few basic tests that are recommended for many young adults, Segal explained.
Many of these are part of yearly visits to your practitioner and/or gynecologist, but it never hurts to ask to ensure you are being tested for them.
Read on to learn more about screening tests all people their 20s should get – plus a few that are important for 20-somethings with specific risk factors.
1. Blood pressure test
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Having high blood pressure means that the force of your blood pushing against your artery walls is consistently too high. Over time, high blood pressure damages the lining of the arteries, and this damage may lead to heart attack and stroke, which can both be deadly.
“High blood pressure is a silent killer because you really don’t present with symptoms until it ends up in a fatality,” Segal said.
That’s why getting your blood pressure tested is so important. Luckily, the test is often part of routine doctor’s appointments.
Blood pressure readings are comprised of two numbers: The first is systolic blood pressure, which indicates how much pressure is on your artery walls when your heart beats; the second is diastolic blood pressure, which indicates the amount of pressure on artery walls when your heart is resting. Any readings of 130/80 or above are considered high, Segal said.
The AHA recommends everyone get their blood pressure checked at least once every two years starting at age 20. If you have high blood pressure, your doctor may recommend more frequent testing.
2. Cholesterol test
There are two types of cholesterol: LDL and HDL. LDL is the “bad” kind that contributes to fatty build-ups in the arteries, and HDL is the “good kind” that helps remove excess cholesterol from the arteries. (Segal offered a handy mnemonic device for remembering which is which: LDL is lousy; HDL is happy.)
If you have too much LDL or too little HDL circulating in your blood, cholesterol can combine with other substances and form thick plaques on the inside of your arteries, narrowing and stiffening them, and increasing the risk of heart attack and stroke, according to the AHA.
Some people get high cholesterol because of genetic factors, but lifestyle factors (like smoking and lack of physical activity) are often the “main culprits” behind the condition, the AHA says. And, as is the case with high blood pressure, you may be totally unaware that you have it.
“High cholesterol usually has no symptoms,” Segal said. “That’s why it’s important to check, especially if you have a family history of heart disease or stroke.”
The AHA recommends everyone get a cholesterol test every four to six years starting at age 20, though people who are at risk for high cholesterol may need to be tested more frequently.
3. HIV test
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Human immunodeficiency virus, or HIV, is the infection that can lead to AIDS if left untreated. In the US, more than 1.1 million people are living with HIV, but there’s a chance they aren’t aware of their status.
“One in seven people with HIV don’t know they have it, so they’re not getting treatment and they may be passing HIV to others without knowing,” Segal said. “Men, women, people of all sexual orientations, all colors, and all ages are getting infected. So it’s really important to get that test in your 20s, especially if you’re not practicing safe sex.”
The Centers for Disease Control and Prevention (CDC) recommends that everyone get an HIV test at least once between ages 13 and 64. People who have unprotected sex or who share injection drug equipment should get tested at least once yearly.
4. Skin cancer check
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Skin cancer doesn’t just happen to older folks who have spent years sunbathing. Melanoma, the deadliest type of skin cancer, is the second-most common cancer among women ages 15 through 29, according to the American Academy of Dermatology (AAD)
Skin cancer symptoms can vary pretty dramatically. The disease may manifest as a changing mole, a sore that won’t heal, or even an unassuming flesh-colored bump, as INSIDER previously reported. It can occur in unlikely places, too, like underneath your nails, or in spots that get no sun exposure at all.
Read more: 9 subtle signs you might have skin cancer
And while skin cancers detected early are almost always curable, the ones that evade detection can become much more serious. That’s why the AAD recommends that everyone perform regular self-checks to look for potential signs of skin cancer. (Here’s a guide that explains the right way to do it.)
But people with certain risk factors, like a family history of skin cancer, long-term sun exposure, tanning bed use, and light skin tone are at a higher risk for the disease and may need a skin check from a dermatologist, Segal said.
People with a personal history of melanoma should always have annual full-body skin checks performed by a dermatologist, the AAD says. For anyone else, a dermatologist can make a personalized recommendation for how often you need a skin exam.
5. The A1C test for type 2 diabetes
“What we look for also in your 20s is diabetes,” Segal said. “We do what’s called a hemoglobin A1C test.”
The A1C test is a blood test that measures your blood sugar levels over the previous three months, according to the US National Institutes of Health. It’s used to identify type 2 diabetes, the condition in which blood sugar is too high because the body can’t use insulin well, and prediabetes, a condition in which blood sugar is higher than normal but not yet high enough to be diabetes.
Knowing whether or not you have type 2 diabetes is crucial, because having the condition dramatically increases your risk for heart disease, according to the Mayo Clinic. Plus, if it’s left untreated, type 2 diabetes may lead to long-term complications like nerve damage, eye damage, and toe or foot amputation.
The American Diabetes Association’s recommendations say all people should be screened for type 2 diabetes starting at age 45, but they add that testing should be considered in adults of any age – even younger ones – if they’re overweight or obese and have at least one risk factor for the disease. These risk factors include high blood pressure, polycystic ovarian syndrome in women, having a first-degree relative with diabetes, physical inactivity, and more. As always, a doctor can help you determine when testing is right for you.
6. Pap smear
The Pap smear looks for abnormal changes in cervical cells before they become cancerous, according to the American College of Obstetricians and Gynecologists (ACOG), meaning any potential problems can be caught early.
The test is done by a doctor who uses an instrument to scrape cells from the cervix in a quick (but mildly uncomfortable) procedure. Then those cells are sent to a lab for analysis, Segal explained.
Doctors used to recommend annual Pap smears. But those recommendations changed in 2012 after studies found that, when it comes to catching cancer, getting a Pap every few years is still just as effective as yearly testing. It also cuts down on unnecessary panic from abnormal results, because cervical cell changes often go back to normal on their own, according to the ACOG.
The ACOG currently recommends that healthy patients aged 21 to 29 get a Pap smear every three years. Anyone who’s under 21 doesn’t need to get the test.
“Previous guidelines recommended the first Pap test occur three years after you’ve had sexual intercourse, but waiting until the age of 21 is now recommended because adolescents have a lower risk of cervical cancer and a higher likelihood of these cervical cell abnormalities that go away on their own,” Segal said.
7. Gonorrhea and chlamydia tests
Chlamydia and gonorrhea are sexually transmitted diseases (STDs) that are both caused by bacteria. (They also happen to be on the rise in the US.)
And, since many people who get these STDs don’t have any symptoms, testing is the only way to know for sure if you’re infected. Testing can be as easy as peeing in a cup – but sometimes a healthcare provider will test for the infections by rubbing genitals with a cotton swab to collect cells.
The CDC recommends that all sexually active women younger than 25 get annual screening tests for both chlamydia and gonorrhea. Women older than 25 with certain risk factors (like new or multiple sex partners) should also get yearly tests for the two infections. And, no matter their age, all sexually active men who have sex with men should get yearly tests for chlamydia and gonorrhea (as well as syphilis), the CDC says.
If you’re unsure exactly which STD tests you should get, ask a doctor. The CDC also has a short quiz that can help you determine which tests you may need.
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