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Health by decade / 02 of 04

Health in your 40s

Your 40s open three screening windows at once: yearly blood pressure, mammography every two years for women from 40, and colorectal cancer screening from 45. It is also the decade the statin question arrives, because the USPSTF's cardiovascular risk assessment covers ages 40 to 75.

Written by the VitalDecades editorial team Reviewed by the editorial review process Updated
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01  /  Screenings

What to get checked in your 40s

Each row names the body that recommends it, the grade it gave, and the date of that recommendation. Recommendations change; the date tells you how current the row is.

Blood pressure

Confirm a high office reading with out-of-office measurement before treatment.

Who All adults 18 and older
How often Every year at 40 and older
Recommendation USPSTF Grade A (2021)

Effective

Prediabetes and type 2 diabetes (A1C, fasting glucose or OGTT)

Who Adults 35 to 70 with overweight or obesity
How often About every 3 years if results are normal
Recommendation USPSTF Grade B (2021)

Effective

Cardiovascular risk assessment and statin decision (lipid panel plus 10-year ASCVD risk)

Grade C at 7.5% to under 10% risk; insufficient evidence at 76 and older.

Who Adults 40 to 75 with at least one risk factor (dyslipidemia, diabetes, hypertension, smoking)
How often At the visit where risk is assessed; statin recommended when 10-year risk is 10% or higher
Recommendation USPSTF Grade B (2022)

Effective

Colorectal cancer screening

Who Adults 45 to 49 (Grade B), then 50 to 75 (Grade A)
How often Colonoscopy every 10 years; FIT every year; sDNA-FIT every 1 to 3 years; CT colonography or flexible sigmoidoscopy every 5 years
Recommendation USPSTF Grade B at 45 to 49 (2021)

Effective

Breast cancer screening (mammography)

Insufficient evidence on supplemental ultrasound or MRI for dense breasts.

Who Women 40 to 74 at average risk
How often Every 2 years
Recommendation USPSTF Grade B (2024)

Effective

Cervical cancer screening

A December 2024 draft update proposes HPV primary screening (clinician- or self-collected) every 5 years at 30 to 65; not final as of 2026-08-19.

Who Women 21 to 65
How often Ages 21 to 29: cytology every 3 years. Ages 30 to 65: cytology every 3 years, hrHPV every 5 years, or cotesting every 5 years
Recommendation USPSTF Grade A (2018)

Effective

Osteoporosis screening (bone density, DXA)

Insufficient evidence for screening men.

Who Postmenopausal women under 65 at increased fracture risk by clinical risk assessment
How often No fixed interval
Recommendation USPSTF Grade B (2025)

Effective

Depression screening

Who All adults, including pregnant and postpartum people and older adults
How often No optimal interval established; screen everyone not previously screened, then by clinical judgment
Recommendation USPSTF Grade B (2023)

Effective

Anxiety disorder screening

Insufficient evidence at 65 and older.

Who Adults 64 and younger, including pregnant and postpartum people
How often No specific interval
Recommendation USPSTF Grade B (2023)

Effective

Unhealthy alcohol use screening and brief counseling

Who Adults 18 and older
How often No interval established
Recommendation USPSTF Grade B (2018)

Effective

Hepatitis C screening

Who Adults 18 to 79
How often One time for most adults; periodically with continued risk
Recommendation USPSTF Grade B (2020)

Effective

HIV screening

Who Adolescents and adults 15 to 65; older adults at increased risk
How often At least once; repeat for people at increased risk
Recommendation USPSTF Grade A (2019)

Effective

Hepatitis B screening

Who Adults at increased risk (born in high-prevalence regions, HIV, injection drug use, men who have sex with men, household or sexual contacts)
How often Risk-based
Recommendation USPSTF Grade B (2020)

Effective

Syphilis screening

Who Nonpregnant adults at increased risk
How often Risk-based
Recommendation USPSTF Grade A (2022)

Effective

Weight and BMI, with referral to intensive behavioral programs when BMI is 30 or higher

The topic is being updated; the 2018 statement remains current.

Who Adults with a BMI of 30 or higher
How often Offer or refer at the visit
Recommendation USPSTF Grade B (2018)

Effective

Influenza vaccine

Who All adults 19 and older
How often One dose every year
Recommendation CDC/ACIP adult schedule (reviewed 2025-07-02)

Effective

Tetanus, diphtheria, pertussis (Tdap or Td)

Who All adults
How often One Tdap, then a Td or Tdap booster every 10 years
Recommendation CDC/ACIP adult schedule (reviewed 2025-07-02)

Effective

Pneumococcal vaccine

Routine vaccination begins at 50.

Who Adults 19 to 49 with certain conditions or risk factors
How often One dose of PCV20 or PCV21; or PCV15 followed by PPSV23
Recommendation CDC/ACIP adult schedule (reviewed 2025-07-02)

Effective

COVID-19 vaccine

CDC's separate COVID vaccine considerations page could not be verified on 2026-08-19; check the current schedule.

Who Adults 19 and older
How often Per the current CDC schedule; the schedule page still expresses this in terms of the 2024 to 2025 vaccine
Recommendation CDC/ACIP adult schedule (reviewed 2025-07-02)

Effective

02  /  Numbers to track

Biomarkers worth knowing this decade

Apolipoprotein B

ApoB

Risk-enhancing factor: 130 or higher mg/dL

Fasting plasma glucose

FPG

Normal (below the prediabetes range): under 100 mg/dL

HDL cholesterol

HDL-C

Low (a major risk factor): under 40 mg/dL

Hemoglobin A1C

A1C

Normal (below the prediabetes range): under 5.7 %

High-sensitivity C-reactive protein

hs-CRP

Low relative risk: under 1 mg/L

LDL cholesterol

LDL-C

Optimal: under 100 mg/dL

Triglycerides

TG

Normal: under 150 mg/dL

What changes in your 40s

Breast cancer screening moved to 40 in the USPSTF's 2024 update, every two years for women at average risk. Colorectal screening starts at 45 (Grade B) and there are several ways to do it, from a yearly stool test to a colonoscopy every ten years. Blood pressure checks become yearly. And from 40, the USPSTF recommends a cardiovascular risk assessment: a lipid panel plus a 10-year risk estimate, with a statin recommended when that risk is 10% or higher and you have at least one risk factor.

For women who reach menopause before 65, the 2025 osteoporosis recommendation adds bone density screening if a clinical risk assessment says you are at increased fracture risk.

Frequently asked questions

Should I get a colonoscopy at 45? ▼

The USPSTF recommends colorectal cancer screening from 45 (Grade B) and lists colonoscopy every 10 years as one option alongside yearly FIT, sDNA-FIT every 1 to 3 years, and CT colonography or flexible sigmoidoscopy every 5 years. Any of them counts; the best test is the one you will actually complete.

Do I need a mammogram at 40 or 50? ▼

Since April 2024 the USPSTF recommends mammography every two years for women 40 to 74 at average risk (Grade B). Earlier guidance started at 50; the current recommendation starts at 40.

What is a 10-year ASCVD risk score? ▼

An estimate of your chance of a heart attack or stroke over the next ten years, calculated from age, sex, cholesterol, blood pressure, diabetes and smoking. The USPSTF recommends a statin at 40 to 75 when it is 10% or higher and you have at least one risk factor.