Preventive medicine, without the hype.
Which check-ups, blood tests and scans actually change outcomes? Health Detectors explains what the evidence shows, grades every recommendation, and says plainly where it is uncertain. No products, no sponsors, no sales.
Every recommendation carries an evidence grade.
Not every test is equally well supported. The grade tells you how solid the ground is before you decide.
High
Several randomized trials, large cohorts or consistent guideline recommendations. Reasonable for everyone who meets the criteria.
Moderate
Good observational data or single trials. Worth a conversation with your physician, weighing your own risk.
Emerging
Plausible and actively researched, but no evidence yet that it improves outcomes. For the curious, clearly labelled.
Not recommended
No evidence of benefit, or harms outweigh benefits. We explain why.
A sensible baseline to discuss with your doctor.
Standard check-ups have not been shown to reduce mortality on their own. What helps is a targeted baseline: markers that are well studied and lead to a clear consequence if abnormal. This is a starting point for a conversation, not a prescription.
Lipids & heart risk
- ApoBCounts all atherogenic particles; more precise than LDL-C alone★★
- Lipoprotein(a)Largely inherited; guidelines suggest measuring it once in adult life★★
- Triglycerides, HDL-C, LDL-CThe standard lipid profile★★★
- Blood pressureThe single most important number★★★
Blood sugar & metabolism
- HbA1c and fasting glucoseDetect diabetes and pre-diabetes★★★
- Fasting insulin / HOMA-IRCan show insulin resistance earlier; no agreed cut-offs★
- Waist circumferenceSimple marker of visceral fat★★
Kidney & liver
- Creatinine / eGFRKidney function; important for drug dosing★★★
- ALT, AST, GGTLiver; normal values do not rule out fatty liver★★
- FIB-4 scoreCalculated from routine labs; flags liver fibrosis risk★★
Blood count & inflammation
- Complete blood countAnaemia and other blood disorders★★
- hs-CRPLow-grade inflammation; adds little to standard heart risk scores★
Selected micronutrients
- FerritinIron stores, especially in menstruating women★★
- Vitamin B12Relevant with metformin, plant-based diet or age over 60★★
- Vitamin DCommon deficiency, but the Endocrine Society (2024) advises against routine testing in healthy adults★
Fitness & body composition
- Cardiorespiratory fitness (VO₂max)One of the strongest predictors of long-term survival★★
- Grip strengthSimple marker of muscle function★★
- Body compositionMuscle and fat distribution beyond BMI★★
TSH (thyroid) is often included in check-ups. Without symptoms, its benefit as a screening test is uncertain; it makes most sense when symptoms or risk factors are present.
Further tests depend on your risk profile.
Age, sex, family history, smoking and the baseline results decide which of these make sense. Criteria differ between countries; your physician knows the current national programmes.
Heart
★★Coronary calcium score (CT), in selected cases exercise testing or echocardiography.
Consider if your calculated heart risk is intermediate and the result would change treatment.
Read the article →Bowel cancer
★★★Colonoscopy, or a stool test (FIT) at regular intervals.
Consider from about 45–50, earlier with a family history of bowel cancer.
Read the article →Lung cancer
★★★Low-dose CT of the chest.
Consider if you have smoked heavily for many years, currently or in the past.
Read the article →Breast & cervix
★★★Mammography within national programmes; HPV and/or Pap test.
Consider according to age and national programme; earlier with high familial risk.
Read the article →Abdominal aorta
★★★One-time ultrasound of the abdominal aorta.
Consider for men from 65, especially current or former smokers.
Read the article →Kidneys
★★★eGFR from a blood test plus albumin in the urine (UACR).
Consider with high blood pressure, diabetes, heart disease or kidney disease in the family.
Read the article →Prostate
★★PSA test after an informed decision; MRI before any biopsy.
Discuss from 50; from 45 with a family history or African descent; from 40 for BRCA2 carriers (EAU).
Read the article →Liver
★★Fibrosis score (FIB-4), ultrasound or elastography.
Consider with overweight, diabetes, metabolic syndrome or regular alcohol use.
Read the article →Skin
★★Full skin examination with dermatoscopy.
Most useful with many moles, fair skin, previous sunburns or family history of melanoma.
Read the article →Whole-body MRI
—Imaging without a specific question.
Not as routine screening. Frequent incidental findings, no proven benefit; reserved for specific high-risk syndromes.
Read the article →Interesting, not yet proven.
These tests are scientifically serious and often advertised. None has shown that it helps people live longer or healthier. If you do them, do them knowing that.
DunedinPACE (pace of ageing)
DNA-methylation measure of how fast you are ageing biologically. Responds to lifestyle in a randomized trial; clinical consequences remain unclear.
★ EmergingMulti-cancer blood tests
Look for tumour DNA in the blood. In the NHS-Galleri trial (2026) fewer stage IV cancers were found, but the main goal, fewer late-stage cancers overall, was missed. Effect on mortality: unknown.
★ EmergingOmega-3 index
Share of EPA and DHA in red blood cells. Associated with cardiac risk; whether raising it helps is not established.
★ EmergingIGF-1, cystatin C, fibrinogen
Useful in specific clinical questions. As general longevity markers, the evidence is thin.
★ Profile-dependentPopular, expensive, and not supported by evidence.
Leaving out a test is a decision too. These are the ones we would not do without a specific medical reason.
How to recognise a good check-up.
This journal does not recommend specific practices or clinics. These questions help you judge an offer yourself.
Signs of a good provider
- Explains for every test why it is done and what follows from an abnormal result.
- Tells you what is not tested, and why.
- Talks openly about false alarms and overdiagnosis.
- Has a clear plan for abnormal findings, including who is responsible for follow-up.
- Gives you all results and reports to keep.
- States the full price before you start.
- Takes time for a real conversation with a physician.
Warning signs
- "Full-body scan for everyone", regardless of risk.
- Packages advertised with 100+ lab values.
- Tumour markers or genetic panels without a reason.
- Results by e-mail without a consultation.
- Supplements, infusions or follow-up products sold on site.
- Pressure to decide quickly or recurring subscriptions.
Independence: Health Detectors has no partners, no sponsors, no advertising and no affiliate links, and receives no payments from providers of medical services.
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Why this journal exists
Health Detectors began as the design for an evidence-based prevention programme. The framework turned out to be more useful in public than behind a booking form. Every article states its evidence and its sources.