After 65, do routine health screenings still truly make medical sense?

Experts explain which health screenings still matter after 65, which are overused, and how personalised decisions can be more useful

Older adults are often advised to undergo regular health screenings, sometimes year after year, regardless of whether they feel unwell. While early detection can save lives, growing medical evidence suggests that routine testing in later life does not always offer clear benefit, and in some cases may cause avoidable harm. As people live longer, doctors are increasingly questioning which health screenings truly matter in older age, which are overused, and how often tests should really be done.

 

“Relying simply on a patient’s chronological age is insufficient in geriatric patients,” says Dr Monika Prabhakar, Group Head – Lab Operations (National & International Labs), Metropolis Healthcare Limited.

 

What matters far more, she explains, is life expectancy, overall health, frailty, existing illnesses, and patient preferences. Why? Because most benefits of screening, especially cancer screening, appear five to ten years down the line, while the risks begin immediately.

 

“As life expectancy declines, the trade-off quickly tilts towards harm,” she notes, adding that two people of the same age can differ dramatically in how well they tolerate investigations or treatments.

 

Which screening tests still save lives after 65 or 70?

 

Dr Prabhakar points out that colorectal cancer screening has the strongest evidence for reducing both cancer incidence and mortality and can benefit healthy adults beyond 65, and sometimes into their early 80s, if life expectancy is adequate.

 

Other tests that continue to matter include:

 

Blood pressure screening, which significantly lowers stroke and heart disease risk

 

Diabetes monitoring, when clinically indicated

 

Osteoporosis screening in women over 65, which reduces fracture-related disability and death

 

Vision, hearing, vaccinations, and fall risk

 

“Screening should protect function and independence, not just chase numbers,” adds Dr Tushar Tayal, Associate Director, Internal Medicine, CK Birla Hospital, Gurugram.

 

When do cancer screenings stop offering real benefit?

 

According to both experts, cancer screening stops making sense when life expectancy is shorter than the time needed to benefit, or when harms outweigh gains.

 

Dr Prabhakar explains:

 

Breast cancer (mammography): Clear benefit up to age 74; beyond that, only for very healthy women with a life expectancy of at least 10 years

 

Prostate cancer (PSA): Little to no mortality benefit after 70, with high risk of overdiagnosis and treatment-related harm

 

Cervical cancer: Can be safely stopped after 65 if previous screenings were adequate and normal

 

Colorectal cancer: Clear benefit up to 75; highly individualised between 76–85; usually stopped after 85

 

Dr Tayal adds that lung cancer screening with low-dose CT rarely helps older adults who quit smoking more than 15 years ago or who have serious illnesses limiting life expectancy.

 

Are annual full-body check-ups in seniors doing more harm than good?

 

While periodic screening is important, blanket annual “full-body check-ups” often lead to over-testing, especially when results aren’t clinically correlated.

 

“Incidental findings, or ‘incidentalomas’, are common in older adults and frequently provoke anxiety,” Dr Prabhakar explains. Many of these findings never cause harm but trigger further tests, biopsies, or procedures that do.

 

Dr Tayal says, “Repeated blood panels, routine vitamin tests without symptoms, and imaging for vague aches often add risk without improving outcomes.”

 

How often do stable seniors really need routine tests?

 

Less often than many people think. For older adults with stable health and no new symptoms:

 

Blood pressure: Every 6–12 months

 

Diabetes (HbA1c): Yearly if stable

 

Cholesterol: Every 3–5 years if on steady treatment

 

Kidney function: Annually

 

Thyroid tests: Every 1–2 years

 

Bone density: Every 3–5 years, depending on risk

 

“More frequent testing rarely improves care unless treatment or symptoms change. Ethically, screening should stop when results will not change management or when harms outweigh benefits,” Dr Tayal says.

 

Should screening be personalised for every older adult?

 

“Absolutely,” say both doctors. Decisions should consider multiple illnesses, medication burden, functional status, and personal goals.

 

For many seniors, spacing out or stopping tests may offer more benefit than continuing them.  For more health updates, follow #HealthWithBS 

This content is for informational purposes only and is not a substitute for professional medical advice.