Why screening matters
Screening means testing people who feel well, to find a problem early when it is easier to treat. In South Africa, almost half of adults have high blood pressure and many people with diabetes don't know they have it. Regular checks change that.
Screening is not "more tests are always better". Unnecessary tests can lead to false alarms, worry and procedures you didn't need. A good plan is targeted to you.
Common checks at a glance
| Check | Who and when (general guide) |
|---|---|
| Blood pressure | All adults, at least every year or two; more often if raised |
| Weight and waist | At routine visits; waist of 94 cm or more (men) or 80 cm or more (women) signals higher risk |
| Blood sugar (HbA1c or fasting glucose) | From age 45, or earlier if overweight with another risk factor; every three years if normal and low risk |
| Cholesterol (lipogram) | From age 40 for everyone; from age 20 with risk factors; childhood testing if there is inherited high cholesterol in the family |
| Cervical screening (HPV test or Pap smear) | Women from about 25 to 30, every 5 to 10 years with HPV testing; from 25, every 3 to 5 years, for women living with HIV |
| Breast screening (mammogram) | Women from 40, ideally every year, or at least every two to three years; earlier for those at high risk |
| Bowel (colorectal) cancer screening | Commonly from 45 to 50; earlier with a family history or symptoms |
| HIV test | All adults should know their status; test regularly if you have ongoing risk |
| Prostate (PSA) discussion | Men, usually from about 50, or earlier with a family history or for Black men; a shared decision with your doctor |
| Eyes, teeth and hearing | Regular checks, especially if you have diabetes |
| Vaccinations | Review at check-ups, for example flu, tetanus and pneumococcal vaccines in later life |
Your 20s and 30s
- Blood pressure, weight and waist checks.
- Cervical screening from about 25 to 30.
- Cholesterol testing if you have risk factors or a family history of early heart disease or very high cholesterol. Inherited high cholesterol is common in some South African communities.
- Blood sugar testing if you are overweight with another risk factor, had diabetes in pregnancy, or have PMOS (previously called PCOS).
- HIV testing and sexual health checks.
- A breast cancer risk assessment by about 25 if there is a strong family history.
Your 40s
- Everything above, plus:
- Cholesterol testing for everyone from 40.
- Mammograms for women from 40.
- Blood sugar testing from 45, or earlier with risk factors.
- Bowel cancer screening may start from 45 to 50, depending on your risk and the guideline your doctor follows.
Your 50s and beyond
- Continue blood pressure, blood sugar, cholesterol, breast and cervical screening as advised.
- Bowel cancer screening if not already started.
- A PSA discussion for men.
- Bone health, balance, muscle strength, memory and mood become increasingly important topics to raise.
- Review your vaccinations and your medicines.
Family history changes the plan
Tell your doctor if a parent, brother or sister has had:
- heart disease or stroke at a young age (men under 55, women under 65);
- diabetes;
- breast, ovarian, bowel or prostate cancer, especially at a young age;
- very high cholesterol.
This may mean starting some checks earlier or doing them more often.
Symptoms are not screening
Screening is for people who feel well. If you have symptoms, such as a breast lump, bleeding after sex or between periods, blood in your stool, unexplained weight loss, chest pain or breathlessness, don't wait for a routine check. See a doctor promptly.
Frequently asked questions
Do I need a "full blood count" or "every test" every year?
Not usually. Tests should be chosen for a reason. Your doctor can tailor checks to your age, history and risk.
Does my medical aid cover screening?
Many medical schemes cover some screening tests as preventive benefits. Check with your scheme, as benefits differ.
I'm healthy and feel fine. Do I still need checks?
Yes. Many conditions, especially high blood pressure, prediabetes and high cholesterol, cause no symptoms until complications develop.
How often should I see a doctor for a check-up?
It depends on your age, health and risks. Your doctor can suggest a sensible interval.
References
- Seedat YK et al. South African hypertension practice guideline 2014. Cardiovascular Journal of Africa. 2014.
- Ampath. Screening and diagnosis of diabetes mellitus using glucose testing. https://www2.ampath.co.za/resources/screening-and-diagnosis-of-diabetes-mellitus-using-glucose-testing
- Ampath. AmpathChat 61: SA dyslipidaemia guidelines. 2019. https://ampath.co.za/storage/416/ampathchat-61-sa-dyslipidaemia-guidelines-17102019-final.pdf
- Ampath. Fast Facts: HPV PCR in cervical cancer screening. March 2026. https://www.ampath.co.za/storage/637/Fast-Facts----HPV-PCR-in-Cervical-Cancer-Screening-Final-March-2026.pdf
- Mediclinic. Mammograms: what are they and do I need one? https://www.mediclinic.co.za/en/infohub-corporate/expertise/cancer/mammograms-what-are-they-and-do-i-need-one.html
- National Department of Health, Stats SA, SAMRC and ICF. South Africa Demographic and Health Survey 2016. https://www.dhsprogram.com/pubs/pdf/DM142/DM142.pdf
This article is for general educational purposes only, like a health newsletter. It is not medical advice, diagnosis or treatment, and reading it does not create a doctor and patient relationship. Please speak to your own doctor about your situation. In an emergency, call 10177 or 112, or go to your nearest emergency unit.