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Screening BODY HANDBOOK
Screening · §97
The Annual Preventive-Exam Cadence
Five appointments catch the diseases you can't feel yet: dentist, eye doctor, skin doctor, a hearing screen, and a yearly primary-care visit. The "annual everything" advice gets the intervals wrong — dental is risk-tailored, hearing runs on a decade-long clock, the skin exam is really for people with risk factors. But the habit underneath is high-leverage: a glaucoma caught with vision left to save, a melanoma still 1mm thick, a hearing loss fitted before it eats a decade of talk.
Screen · Yearly Evidence Emerging Chapter Screening

These conditions are silent until they aren't. Glaucoma takes peripheral vision before you notice; high blood pressure runs symptomless for years. Melanoma caught at 1mm has 99% five-year survival; once it spreads that falls below 35% 1. A cadence catches the finding while the fix is still small.

The appointments aren't equal, and lumping them together flatters the weak ones. The comprehensive physical is weakest: across 17 trials and 250,000 people, health checks moved all-cause, cancer, and cardiovascular mortality not at all 2. Its value is the referral hub: attend a yearly visit and you get 88% of your due screens against 63% otherwise 3.

Hearing is the piece almost everyone undercounts. Untreated hearing loss is the largest fixable mid-life dementia risk we know, about 8% of cases 4; hearing aids slowed cognitive decline by roughly 48% in older adults at elevated risk 5. The screen takes ten minutes, and most adults never get it.

Pick one anchor month and book the whole stack in one sitting. Your birthday works. The intervals below are an average-risk default; compress any line where you carry its risk factor.

Calendar reminders lose to a six-week waitlist and your own forgetting; one annual scheduling pass beats them.

Most of the win never announces itself. A melanoma removed at 1mm with a short biopsy, instead of the stage-III version five years on 1. Blood pressure caught at 110/90 and walked back before it reaches 165/110. The rest is the relationship: your ophthalmologist compares this year's optic-nerve photo against last year's, and a worrying symptom starts with someone who knows your normal 10. It buys a decade of no surprises, and the one year a routine visit is why you're still here.

The fine print — when to skip it, and what people get wrong

"My annual physical covers everything." The physical doesn't lower mortality 2; the screens riding on it do. "Skin cancer is a sun-worshipper problem." Indoor-mostly adults get melanoma too 8.

Skipping the visit that catches nothing: you can't tell those from the one that matters until you're in the chair. And once you have one of these diseases, the yearly screen isn't enough; you move to specialist surveillance 11.

References
  1. 1National Cancer Institute (2024). SEER Cancer Statistics: Melanoma of the Skin — 5-Year Relative Survival by Stage. link
  2. 2Krogsbøll LT, Jørgensen KJ, Gøtzsche PC (2019). General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database of Systematic Reviews. link
  3. 3Beckman AL, Becerra AZ, Marcus A, et al. (2019). Association of Medicare's Annual Wellness Visit with Cancer Screening, Referrals, Utilization, and Spending. Health Affairs. link
  4. 4Livingston G, Huntley J, Sommerlad A, et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. link
  5. 5Lin FR, Pike JR, Albert MS, et al. (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. The Lancet. link
  6. 6Clarkson JE, Pitts NB, Goulao B, et al. (2020). Risk-based, 6-monthly and 24-monthly dental check-ups for adults: the INTERVAL three-arm RCT. Health Technology Assessment. link
  7. 7American Academy of Ophthalmology (2025). Comprehensive Adult Medical Eye Evaluation Preferred Practice Pattern. link
  8. 8American Academy of Dermatology (2024). Detect skin cancer: How to perform a skin self-exam. link
  9. 9ASHA (1997). Guidelines for Audiologic Screening. link
  10. 10Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH (2018). Continuity of care with doctors — a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. link
  11. 11USPSTF (2022). Screening for Primary Open-Angle Glaucoma: US Preventive Services Task Force Recommendation Statement. JAMA. link
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