#routine labs

Lipid Panel

- The 2026 ACC/AHA Dyslipidemia Guideline recommends screening with a lipid profile starting at age 19, then at least every 5 years in healthy adults, with more frequent screening for those with additional ASCVD risk factors. The USPSTF similarly supports lipid screening every 5 years beginning at age 40.[2][3][4]

Glucose / HbA1c

- The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35–70 with overweight or obesity (B recommendation). The American Diabetes Association recommends universal screening starting at age 45 regardless of weight, with repeat testing at minimum every 3 years if results are normal. For those with prediabetes, annual reassessment is recommended.[5][6][7]

Kidney Function (Creatinine/eGFR)

- The 2026 AHA/ACC/ADA/ASN CKM Guideline recommends eGFR assessment at least every 5 years in healthy adults (CKM stage 0), increasing to every 2–3 years in those with overweight/obesity (CKM stage 1), and annually in those with established metabolic risk factors (CKM stage 2+). UACR should be added for CKM stage 2 and above.[6]

CBC

- There is no USPSTF recommendation for routine CBC screening in asymptomatic adults. A CBC is recommended as part of the workup for specific conditions (e.g., hypertension evaluation per the 2025 AHA/ACC BP guideline) but is not an evidence-based annual screening test for healthy adults.[8]

Hepatitis C

- One-time screening for all adults aged 18–79 years (USPSTF B recommendation).[9]

Blood Pressure

- Screening annually for adults ≥40 years; every 3–5 years for adults aged 18–39 without risk factors.[4][10]

Summary by Risk Profile

TestHealthy Adult (No Risk Factors)Overweight/Obese or Risk FactorsReferencesLipid panelEvery 5 years (starting age 19–40)More frequently based on risk[1], [2]Glucose/HbA1cEvery 3 years (age 35–70 if overweight/obese; age 45+ per ADA)Every 1–3 years[3]Creatinine/eGFREvery 5 yearsEvery 2–3 years (overweight); annually (metabolic risk factors)[4]UACRNot routinely neededAnnually if CKM stage ≥2[4], [5]CBCNot routinely recommendedAs clinically indicated[6]Hepatitis COnce (ages 18–79)Once[7]

The key takeaway is that for a truly healthy, asymptomatic adult without risk factors, comprehensive annual lab panels are not supported by current evidence. Screening should be targeted based on age and risk profile, with most labs checked every 3–5 years rather than annually.[1] The annual visit itself remains valuable for blood pressure measurement, BMI assessment, counseling, immunization updates, and cancer screening discussions, even when labs are not indicated.

Would you like to explore how screening recommendations change for adults on chronic medications (e.g., statins, antihypertensives) who require more frequent lab monitoring?

References

General Health Checks in Adult Primary Care. Liss DT, Uchida T, Wilkes CL, Radakrishnan A, Linder JA. JAMA. 2021;325(22):2294-2306. doi:10.1001/jama.2021.6524.

2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Blumenthal RS, Morris PB, Gaudino M, et al. Journal of the American College of Cardiology. 2026;:S0735-1097(25)10254-4. doi:10.1016/j.jacc.2025.11.016.

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. JAMA. 2016;316(19):1997-2007. doi:10.1001/jama.2016.15450.

Cardiovascular Risk and Statin Eligibility Of Young Adults After an MI: Partners YOUNG-MI Registry. Singh A, Collins BL, Gupta A, et al. Journal of the American College of Cardiology. 2018;71(3):292-302. doi:10.1016/j.jacc.2017.11.007.

Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. JAMA. 2021;326(8):736-743. doi:10.1001/jama.2021.12531.

2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Writing Committee Members, Ndumele CE, Rodriguez F, et al. Circulation. 2026;. doi:10.1161/CIR.0000000000001453.

2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Ndumele CE, Rodriguez F, Dixon DL, et al. Journal of the American College of Cardiology. 2026;87(22S):e1889-e2007. doi:10.1016/j.jacc.2026.03.056.

2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Jones DW, Ferdinand KC, Taler SJ, et al. Journal of the American College of Cardiology. 2025;86(18):1567-1678. doi:10.1016/j.jacc.2025.05.007.

Screening for Hepatitis C Virus Infection in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement. US Preventive Services Task Force, Owens DK, Davidson KW, et al. JAMA. 2020;323(10):970-975. doi:10.1001/jama.2020.1123.