In short
A full body check up is only as good as the tests inside it, and the standard executive package contains several that do not earn their place.
- Whole body scanning is not a recommended screen. It finds a great deal that was never going to matter.
- Multi cancer blood tests: in a study of 6621 adults, a cancer signal was found in 1.4 per cent, and 62 per cent of those were false positives. No study has shown they improve outcomes.
- Ovarian cancer screening is not recommended at average risk, and clinical breast examination and breast self examination are not recommended either.
What is included instead: the screening tests with mortality evidence for your age and sex.
Treatment Overview
What is actually included?
The screening with randomised evidence behind it, matched to your age and sex, plus a proper cardiovascular risk assessment.
| Cardiovascular risk | Blood pressure, lipids, glucose, kidney function, weight, run through a validated calculator. Every three to five years from 20 |
| Colorectal cancer | From 45 at average risk, continuing while life expectancy is at least 10 years |
| Breast cancer | Discussed from 40, every one to two years by preference, with the harms stated |
| Cervical cancer | From 21 to 25, method and interval depending on the test used |
| Lung cancer | Annual low dose CT for those at increased risk, which is defined by smoking history |
| Prostate cancer | A discussion from 50, or 40 to 45 at high risk. A discussion, not an automatic test |
What is deliberately left out?
- Whole body scanning. Not a recommended screening test. It generates incidental findings that then have to be excluded, each with its own risk
- Multi cancer detection blood tests. Commercially available, clinically unproven. No study has shown they reduce cancer deaths
- Ovarian cancer screening at average risk. Not recommended
- Clinical breast examination and breast self examination. Not recommended as screening
- Routine melanoma screening at average risk. Reserved for those at high risk, with expert skin examination
- Biological age tests and broad undirected panels
Why not the multi cancer blood test?
In a prospective study of 6621 adults aged 50 and over, a third of whom already had a cancer history or predisposition, a cancer signal appeared in 1.4 per cent. Of those, 38 per cent had cancer and 62 per cent did not.
Most participants then had further tests and imaging. Procedures were carried out in 30 per cent of those with a false positive result. Median time to resolution was 57 days for true positives and 162 days for false ones.
Those tests are also designed as adjuncts to standard screening, not replacements for it, and they often do not say which organ the signal came from.
Why is more testing not safer?
Because harm from screening arrives immediately and benefit arrives years later. For colorectal and breast screening, you need to live 10 years to have a 1 in 1000 chance of your life being extended, and 16 years for 2 in 1000.
An overdiagnosed cancer, by contrast, is treated, often surgically, within weeks.
Who Is a Good Candidate?
- You are due for age appropriate screening and want it organised in one place
- You have been offered a comprehensive package and want to know which parts are worth paying for
- You have never had cardiovascular risk formally calculated
- There is cancer or early heart disease in your family and you want the screening plan adjusted for it
- You would rather have fewer tests and better explanations
- An active symptom, which needs investigating as a symptom rather than being absorbed into a screening package
- You specifically want a whole body scan or a multi cancer blood test, neither of which is offered
- Unexplained weight loss, bleeding, a lump or a persistent change in bowel or bladder habit, which need assessment now
What Happens During the Consultation
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1
Age, sex, risk and family history
Which screening applies to you is determined by these four things. Family history on both sides matters for breast, ovarian and colorectal cancer, and a concerning history means a genetic referral rather than more scans.
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2
The screening list, with harms stated
Each recommended test is named with its benefit and its harms. Mammography carries a substantial risk of false positives and overdiagnosis, and you are told that before deciding rather than after.
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3
Cardiovascular risk in the same visit
Blood pressure, lipids, glucose and kidney function through a validated calculator, because this is where the largest preventable burden in this age group sits.
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4
A schedule rather than a single event
Intervals set per test, and a date for the next review: every three years under 50 without chronic conditions, yearly from 50.
Program Structure & Follow-Up
Intervals, by test
| Cardiovascular risk | Every three to five years from 20, yearly at borderline risk or above |
| Blood pressure | Yearly from 40, or every three to five years from 18 to 39 if normal and no risk factors |
| Breast | Every one to two years from 40, by preference |
| Colorectal | Interval depends on the method chosen, from 45 |
| General review | Every three years under 50, yearly from 50 |
What happens with an abnormal result?
It is followed up specifically, with a named next test and a date, not rolled into next year’s package. Where a result is borderline, you are told that it is borderline and what that actually means.
When does screening stop?
Breast and colorectal screening are continued while life expectancy is at least 10 years, which for most people means stopping somewhere between 75 and 85.
Stopping is a decision rather than neglect, and it is worth discussing years in advance. The probability of benefit falls with age while the probability of harm from overdiagnosis rises.
Why does the first check find more than later ones?
Because the first round picks up everything that has accumulated over years. Later rounds find only what has appeared since, so fewer cases and a higher proportion of false positives among the positive results.
That is why a second annual check finding nothing is not a sign the first one was wasted.
Benefits, Limits & Safety
What this delivers
The screening with mortality evidence for someone your age and sex, a calculated cardiovascular risk, and a clear statement of what was deliberately not done and why.
Where screening works, it works well. Colonoscopy followed by early treatment prevented about two thirds of colorectal cancer deaths in one large case control study, and low dose CT reduced lung cancer mortality by 20 per cent in the right group.
The harms, stated plainly
- False positives, and the anxiety and further testing that follow
- Complications of the diagnostic tests that follow a positive screen
- Overdiagnosis: treating a cancer that would never have caused harm. Autopsy studies found prostate cancer in 30 per cent of men in their 50s and 83 per cent in their 70s
- Cost, and the displacement of things that would have helped more
An honest note about the check up itself
General health checks did not reduce mortality in a meta analysis of 14 randomised trials covering over 180,000 people, though they improved blood pressure, cholesterol and BMI.
So the value of this appointment is in the decisions that come out of it, not in its comprehensiveness. Screening at less than 100 per cent uptake is the correct outcome when people have been properly informed.
Declining a test is a legitimate choice
Some people, told the benefits and harms of mammography, choose not to have it. That is a reasonable decision, particularly as breast cancer mortality has fallen with better treatment, and it is accepted rather than argued with.
Where screening works
Colonoscopy prevented about two thirds of colorectal cancer deaths, and low dose CT cut lung cancer mortality by 20 per cent in the right group.
Intervals per test
Cardiovascular risk every three to five years, breast every one to two years from 40, colorectal from 45, general review every three years under 50 and yearly after.
Not included
Whole body scans, multi cancer blood tests, ovarian screening at average risk, clinical breast examination and biological age tests.
Cost & Program Investment
The consultation and each test are quoted separately before anything is booked, so the total is known in advance. There is no comprehensive package and no tiers, because a more expensive tier would mean more tests rather than better ones, and several of the tests that fill executive packages have no evidence of benefit. If a test does not apply to you, it is named and left out rather than added to make the offering look complete.
Frequently Asked Questions
It is not a recommended screening test. It produces incidental findings that then have to be excluded, each with its own risks, and there is no evidence it reduces deaths.
Clinically unproven. In a study of 6621 adults, 62 per cent of positive signals were false, procedures were done in 30 per cent of those false positives, and no study has shown these tests reduce cancer deaths.
That is a discussion rather than an automatic test, starting at 50 at average risk, or 40 to 45 if you are at higher risk. Your own preferences about outcomes are the deciding factor.
Not at average risk. It is not recommended. A concerning family history is a reason for genetic assessment, not for routine screening.
General health checks did not reduce mortality in randomised trials, although they improved blood pressure and cholesterol. The value is in what gets decided and acted on, which is why fewer, better justified tests beat more.
Breast and colorectal screening continue while your life expectancy is at least 10 years, which usually means somewhere between 75 and 85. The benefit takes years to arrive while the harm from overdiagnosis arrives immediately.
You will be told which tests have no evidence of benefit for you and why, and those will not be ordered. The point of the appointment is a defensible list, not a long one.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
- Cardiovascular diseases
- Cardiovascular disease: risk assessment and reduction
- Hypertension in adults: diagnosis and management
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.