I’ve recently had my winter flu vaccine and thank the lord I made it – partly to protect myself, and partly to stop the relentless text reminders as to when and where this sainted jab was taking place. No less than four reminders in a 48-hour period. I can’t begin to imagine the number of missed appointments each year, disrupting what is truly the herculean task of vaccinating the nation.

The same goes for the NHS screening programmes and health checks which come round at certain milestone years. They’re an important opportunity to identify potential health problems early, often before symptoms appear and when they may be most treatable.

As we age, here are the checks that everyone should show up to.

Turning 40 – the standard health check

Turn the corner of 40, and you can look forward to an invitation for a free NHS health check, aimed at identifying conditions which are typically silent – namely high blood pressure, blood sugar and cholesterol. Often these can creep up stealthily and without symptoms, until the damage becomes severe enough to be apparent. Together or in isolation, these conditions can generate heart and vessel disease, strokes, kidney failure, sight loss – and even dementia.

You remain eligible for a check every five years between the ages of 40 and 74, assuming the tests come back clear. And they’re worth it. Even the most outwardly healthy patients I have seen in my practice can have a silently raised blood pressure or cholesterol. These conditions become increasingly common with age, making our forties a sensible starting point to begin screening. And it should continue into your fifties and beyond, to keep a watchful eye on your health.

The appointment and screening time is quick and straightforward: some questions about symptoms and lifestyle, a few measurements (including height, weight and blood pressure), plus some simple blood tests, including cholesterol and sugar levels. It’s a short appointment that could make a big difference to your health further down the line.

The next milestone opens the door to another form of health check: screening for specific diseases, namely cancer. Our risk of developing cancer typically increases with age, too, and at the age of 50, breast and bowel cancer are two important examples to screen for. Some readily accessible tests can identify suspicious changes early, when treatment is more likely to be effective.

Breast cancer screening is available for women from age 50, and is repeated every three years – again, assuming results are clear. The screening tool is a mammogram; a specialised X-ray scan of the breast tissue, allowing any suspicious masses or tissue changes to be detected. This screening doesn’t replace regular examination, however – it’s still really important for women to examine their breasts frequently, checking across the whole breast, including the nipple and the tail, which trails towards the armpit, whilst not forgetting inside the armpit itself. Any new changes including lumps, swellings, or skin changes should always be discussed urgently with a GP.

For both sexes, bowel cancer screening also becomes available at 50 – with a test that you only have to walk to a postbox for, or at least initially. The faecal immunochemical test (FIT) essentially involves taking a small sample of your stools (and I mean tiny, not the whole bowel movement!) and sending it off by post for analysis. This is to see if there are any trace amounts of blood in it, which might otherwise have gone unnoticed. If above a certain threshold level, patients are then invited to attend for an endoscopy – a camera test which explores the inside of the colon in more detail, and allows biopsies to be taken.

Again, bowel tumours can prove stealthy and silent, sometimes not causing any symptoms until such time as they’re large enough to obstruct the passage of stools, generating abdominal pain, distension and vomiting. By that time, there’s a greater likelihood of them having spread to other organs such as the liver, making treatment and recovery more difficult.

This is particularly relevant for tumours which grow in the widest part of the bowel – the caecum – where obstruction may not occur until later. And I’ve seen patients whose early and small caecal tumours were picked up by screening way before symptoms may have appeared, and who went on to make amazing recoveries.

It’s important to remember that other conditions can cause blood in the stool, so a positive test does not always mean cancer. It’s also very important to report any concerning symptoms between screening tests to a doctor. These red flags include change in bowel habit, rectal bleeding, and unexplained weight loss. Please don’t wait until your next screening appointment to get these sorts of symptoms checked out – which I’ve also seen some patients do. Excessive delay could have serious consequences.

Turning 55 – get your lungs checked

At 55, another opportunity knocks. The lung cancer screening is a relatively new addition to the list, introduced as a new health check in 2019, before becoming a screening programme in England. It’s not currently available in all areas of the UK, but is targeted at early diagnosis of lung cancer in patients who smoke currently, or have previously. This may involve a chest CT scan, which can help diagnose abnormalities in lung or airway tissue.

You’d have thought that turning 60 would usher in yet more invites. But actually you’ll have to wait another five years – and be male – for that to happen.

At 65, men are invited for a one-off screening appointment to identify a potentially dangerous condition that can evolve insidiously: an abdominal aortic aneurysm, or AAA – which males are at an increased risk of developing.

The aorta is the largest artery in the human body, carrying litres of blood every minute. An aneurysm refers to a ballooned segment of the artery, where the vessel wall becomes thinner, weaker and liable to pop or rupture. Given the sheer amount of blood that passes through it, you can imagine that a burst aorta can prove catastrophic.

Luckily, a screening programme has been developed, where a simple ultrasound scan examines the section of the aorta passing through your abdomen and looks for any signs of an aneurysm developing. Smaller aneurysms can be monitored, whereas a surgical procedure is available to mend any defects – something that is best completed electively, rather than on an emergency basis. Sadly, many patients who suffer a ruptured aorta whilst outside a hospital will not survive it. So, men, another very compelling reason to keep that important appointment and get checked out.

Whilst invitations to certain screening programmes end at certain ages – 71 for breast cancer, 75 for bowel – you can still self-refer if you’d like to continue being checked out.

There are also private tests for conditions the NHS doesn’t routinely screen for, including prostate and ovarian cancer, using additional blood tests and medical imaging. However, unlike established NHS programmes, these tests haven’t been shown to offer more benefits than harms when used to screen the general population. For example, PSA blood tests can sometimes suggest prostate cancer when none is present, as PSA can be raised in many benign conditions. The same can be said for ovarian cancer screening – and using blood tests and ultrasound hasn’t been shown to significantly reduce deaths from the disease.

Such tests can therefore cause false alarms, lead to unnecessary investigations and treatment, or offer false reassurance when a disease is missed. It’s therefore worth discussing them with a doctor before paying for one – particularly as appropriate investigations are available through the NHS when symptoms are suggestive of underlying disease.

My feeling? Ignore my initial facetiousness about being badgered by constant NHS reminders, and listen to what they’re saying. It’s ultimately your choice whether to take up these invitations, but they’re rolled out for a reason. Having seen many a patient whose lives have literally been saved by screening, and having now turned 40 myself, I’m going to be taking everything that’s available. Even if it means putting up with a few more messages on my phone.