What to Expect at Your Annual Physical

Lori M. Noble, MD, a primary care physician at Spruce Internal Medicine, located at the new Penn Medicine Washington Square building, discusses what to expect at your annual physical.

Lori M. Noble, MDGoing to the doctor for your annual physical can be nerve-racking. You have questions and concerns, your doctor has a separate agenda full of blood tests, studies and vaccines, and all of this typically needs to be addressed in 30 minutes.

To help you avoid feeling overwhelmed, take a look below at tests your doctor may address at your next physical based on the latest United States Preventative Services Task Force recommendations.

Cholesterol Blood Test

WHO: Women over the age of 45 and men over the age of 35, every 5 years.

WHY: Cholesterol levels help predict risk of future heart attack and stroke. If, along with other risk factors, cholesterol levels point to an elevated risk, your doctor may suggest changing your diet, exercising more, and/or medication.

NOTE: Depending on conditions, such as diabetes or strong family history of cholesterol or heart disease, your doctor may start checking earlier and more frequently.


WHO: All women and men age 50-75, every 10 years.

WHY: To detect and remove colon polyps, which could turn into colon cancer if left untreated.

NOTES: (1) If you have colon polyps, you will likely need to return for a repeat colonoscopy in 3-5 years. 2) The colonoscopy is the best test for colon cancer screening, but there are alternatives. Ask your doctor about this option if you are unable to complete a colonoscopy. 3) If you have a strong family history of colon cancer (i.e. a parent or sibling), your doctor may refer you for a colonoscopy earlier.

Abdominal Ultrasound

WHO: One time in men age 65-75 who smoke or who have previously smoked cigarettes.

WHY: To detect an aneurysm of the aorta (the largest blood vessel in the body), for which male smokers are at increased risk.

NOTE: If an aneurysm is detected, you will likely need periodic repeat ultrasounds. If the aneurism is large, surgery may be recommended.

Pap Smear

WHO: All women from the age of 21-65, every 3-5 years

WHY: To detect HPV (human papilloma virus), the virus that can cause changes to the cervix, which ultimately can turn into cervical cancer if not treated.

NOTE: You may need to be checked more often if the result comes back abnormal.


WHO: All women from the age of 50-74, every 1-2 years; women aged 40-49 should have a discussion with their doctors to determine if they should be screened.

WHY: To detect breast cancer in its early stages.

NOTE: If a strong family history of breast cancer (i.e. your mother or sister) exists, you may be referred for mammography earlier.

Bone Density Testing (aka - DEXA Scan)

WHO: All women over 65, every 2 years.

WHY: To detect low bone density, called osteoporosis, which increases the risk of fractures.

NOTES: 1) Women with risk factors for osteoporosis (such as a smoking history, a family history, low body weight, or history of fracture) are recommended to start screening at age 60. 2) There is no agreed upon age at which to stop screening at this time.

So now when it’s time to schedule your yearly physical, be prepared and armed with the knowledge about what to expect.

Annual screenings infographic

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