What does a standard annual physical include for a healthy adult
Longetic stores whatever your checkup produces, from any clinic in any country, and charts each value across the years. There is no standard. No health authority recommends the bundled annual physical exam for a healthy adult, and the tests inside one vary so much by country that the same 45-year-old would get a blood count in Warsaw, a cholesterol test in London and neither in Amsterdam.
The word "standard" is doing a lot of work in that question, and it is worth taking apart. Two different things get called an annual physical.
The first is a bundle: a visit, an examination, and a panel of blood tests, sold or offered as one product. The second is a set of individual screening tests, each recommended separately for a specific age and a specific interval, that happen to be convenient to do on the same day. Guidelines recommend the second. Almost nobody recommends the first.
That distinction is why a reader in Poland and a reader in the Netherlands, both doing what their national system tells them, end up with completely different sets of numbers in front of them. The habits underneath those numbers are a separate list, and we cover the eleven habits behind those checks on their own page.
Does any authority recommend an annual physical
Longetic does not tell you whether to book one, and this section is not advice either way. No, in the United States, the Preventive Services Task Force grades individual services and issues no recommendation for or against the bundled periodic physical examination. In Medicare, the yearly visit that does exist is explicitly not a physical exam.
The strongest evidence against the bundle is a Cochrane review of general health checks covering 16 trials and 182,880 participants. Across 9 trials and 155,899 participants it found a risk ratio of 0.99 for total mortality (95% CI 0.95 to 1.03), 1.03 for cardiovascular mortality and 1.01 for cancer mortality. The authors' conclusion: "General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased."
The counterweight is a 2021 JAMA review of 19 randomised trials and 12 observational studies, which found real benefits that are not mortality: better detection and treatment of hypertension and depression, moderate improvements in blood-pressure and cholesterol control, higher uptake of colorectal and cervical screening, and better patient-reported health. Both results are true at once. A general health check does not appear to make you live longer, and it does appear to get some specific things done.
Medicare is the clearest case of the label misleading people. The Annual Wellness Visit sounds like a physical and is not one. The CMS chart answers the question directly: "No. The AWV is not a routine physical that some older adults may get periodically from their physician or other qualified non-physician practitioner." Laboratory tests are not part of it. Medicare.gov repeats the point for patients: "It isn't a routine physical exam." Outside Medicare the same caution applies to cost: whether your plan pays for it depends on the plan, not the exam.
Which tests have evidence behind them, and at what age
Longetic charts each of these across every report you upload, which is the part that makes an interval visible rather than theoretical. A short list of individual screening tests carries an A or B grade from the US Preventive Services Task Force, and each has its own starting age and its own interval. Most of them are not annual.
| Test | Grade | Who | Interval | Year |
|---|---|---|---|---|
| Blood pressure | A | adults 18+ | yearly at 40+, every 3 to 5 years at 18 to 39 | 2021 |
| Prediabetes and type 2 diabetes | B | 35 to 70 with overweight or obesity | every 3 years is reasonable | 2021 |
| Colorectal cancer | B at 45 to 49, A at 50 to 75 | adults 45 to 75 | annual FIT or colonoscopy every 10 years | 2021 |
| Cervical cancer | A | 21 to 65 | cytology every 3 years, hrHPV every 5 | 2018 |
| Breast cancer | B | women 40 to 74 | every 2 years | 2024 |
| Hepatitis C | B | adults 18 to 79 | once, more if ongoing risk | 2020 |
| HIV | A | 15 to 65 | no optimal interval set | 2019 |
| Lung cancer, low-dose CT | B | 50 to 80, 20 pack-years | yearly | 2021 |
| Osteoporosis | B | women 65+, younger postmenopausal with risk factors | not specified | 2025 |
The interval column is where the annual habit breaks down. Mammography is biennial. Diabetes screening is every three years. Cervical screening runs on three or five. Hepatitis C is once in a lifetime for most people. An annual visit that repeats all of these every year is not following the guideline more closely, it is following it less. Which markers are worth repeating, and how often each one actually changes, is a separate question from how often you see a doctor.
Which common annual-physical tests have no recommendation
Longetic stores a result whether or not a guideline asked for it, and does not tell you what any of it means. Several tests that people expect to find in an annual physical carry no recommendation for asymptomatic adults, and one carries a recommendation against. That includes routine thyroid screening, routine vitamin D screening and the resting ECG.
| Test | Status for asymptomatic adults | Source |
|---|---|---|
| Thyroid function | insufficient evidence, grade I | USPSTF 2015 |
| Vitamin D | insufficient evidence, grade I | USPSTF 2021 |
| Resting or exercise ECG, low risk | recommended against, grade D | USPSTF 2018 |
| PSA, men 70+ | recommended against, grade D | USPSTF 2018 |
| PSA, men 55 to 69 | individual decision, grade C | USPSTF 2018 |
| Annual screening blood count | advised against without a clinical indication | Choosing Wisely Canada |
Choosing Wisely Canada states it as an instruction to clinicians: "Do not do annual screening blood tests unless directly indicated by the risk profile of the patient." A grade I is not the same as a grade D, and neither means a test is useless. It means the evidence does not support doing it to everybody, every year, in the absence of symptoms.
What is the European equivalent of an annual physical
Longetic is the copy of the record that stays with you when you change country, which is why this table exists at all. There is no European equivalent, there are five different national answers. England checks once every five years, Germany every three, France at four life stages, Poland every three to five years with a blood panel, and the Netherlands has no general programme.
| Country | Programme | Who and how often | What is in it |
|---|---|---|---|
| England | NHS Health Check | ages 40 to 74, every 5 years, excluding people already diagnosed | height, weight, waist, blood pressure, cholesterol test, blood sugar check |
| Germany | Gesundheitsuntersuchung, Check-up 35 | once at 18 to 34, then every 3 years from 35 | examination, blood lipids and fasting glucose, urine test, one-off hepatitis B and C screening from 35 |
| France | Mon bilan prevention | four windows: 18 to 25, 45 to 50, 60 to 65, 70 to 75 | a 30 to 45 minute consultation on risk, lifestyle, screening and vaccination status, not a test panel |
| Poland | Moje Zdrowie, from 1 May 2025 | everyone 20+, every 5 years at 20 to 49, every 3 years at 50+ | blood count, glucose, creatinine and eGFR, full lipid panel, TSH, urinalysis, extras by age and risk |
| Netherlands | none | not offered as a general programme | occupational health examinations exist, they are employer-driven and voluntary |
| Spain | none defined in Real Decreto 1030/2006 | not applicable | not defined nationally |
Poland is the interesting row. Its national programme routinely includes a blood count, a urinalysis and a TSH for every adult from 20, which are three of the exact tests the US task force and Choosing Wisely say have no evidence base for asymptomatic people. Two health systems, the same evidence, opposite policies. If you have ever wondered why a checkup in one country feels thorough and in another feels like nothing happened, this table is the reason.
France is the other surprise. Mon bilan prevention is a structured conversation rather than a panel, delivered by a doctor, nurse, pharmacist or midwife, working through risk, lifestyle, screening status and, from 60, loss of autonomy. There is no blood draw attached to it by default.
Does Spain have an annual health check for adults?
Spain's national portfolio of services, Real Decreto 1030/2006, defines no scheduled general examination for a healthy adult. Its consolidated text was last updated on 31 July 2026, and the primary care annex sets out vaccination, chemoprophylaxis and screening rather than an appointment. The only age-indexed entitlements it gives an adult without symptoms are the three population cancer screening programmes, and each comunidad autónoma delivers those.
The legal text is most telling for what it does not contain. The primary care annex describes preventive activity as "Actividades para prevenir la aparición de enfermedades actuando sobre los factores de riesgo (prevención primaria)" and "o para detectarlas en fase presintomática mediante cribado o diagnóstico precoz (prevención secundaria)". Its adult section is headed "Atención al adulto, grupos de riesgo y enfermos crónicos" and lists conditions a person has already been diagnosed with, among them "Diabetes mellitus" and "Hipertensión arterial". The one entry addressed to a healthy adult by age alone is "6.4.6 Detección precoz de cáncer colorrectal". The phrases examen periódico de salud, chequeo and revisión anual do not appear in the consolidated text at all.
Spain also draws a line that most countries leave implicit, between screening you are invited to and screening you ask for. The Ministry of Health framework document on population screening defines the second kind: "El cribado oportunista es una actividad no sistemática que se suele realizar dentro de los servicios de salud", done "a petición del interesado o aprovechando una consulta por otro motivo médico". A population programme, by contrast, "es aquel que se ofrece activamente a toda la población diana, de manera sistemática". That document prints no publication date of its own, so we give it no year here. A private Spanish chequeo sits on the opportunistic side of that line, and nothing in the national portfolio puts it on the other one.
The professional reference point inside Spanish primary care is PAPPS. semFYC describes it as "un proyecto de la Sociedad Española de Medicina de Familia y Comunitaria (semFYC)", says it "mantiene un convenio de colaboración con el Ministerio de Sanidad", and reports "688 centros de salud del Estado Español adscritos formalmente". Its 2024 update is a special issue of eleven articles: an editorial, a piece on the European prevention network and nine topic-specific updates covering lifestyle, vascular prevention, cancer, vaccines, mental health, older people, women, and children and adolescents. Not one of them is a periodic general examination. PAPPS is candid about how unevenly any of it lands, writing that "la implementación y la prestación de servicios preventivos es variable y muchas veces insuficiente". We read the semFYC programme page, the 2022 update page and the contents list of the 2024 special issue, and found no PAPPS document taking a position for or against a general check-up.
One more thing follows from how Spain is governed, and it changes the answer depending on where you live. The consolidated national text sets colorectal screening at "Población objetivo: hombres y mujeres de edades comprendidas entre 50 y 74 años". The Comunidad de Madrid, on its own page for the programme, last updated 17 September 2026, says Prevecolon "Está dirigido a toda la población de edad comprendida entre los 50 y 69 años" and that "Es necesario repetir el test cada dos años para que la prevención del cáncer sea efectiva". Both are official, both are current, and they are five years apart at the top end. Who invites you to a check in England and in Spain, and at what interval, is a separate piece.
What do you keep after the appointment
Longetic reads the PDF your laboratory sends and charts each biomarker across every report, so this year's cholesterol sits next to the one from three years ago instead of in a different inbox. What matters afterwards is not the visit, it is the numbers and the dates, because the value of a repeated test comes from the comparison and the comparison needs the old result.
This is the practical problem with moving between systems, and with changing clinics inside one. A result from a Berlin practice, a result from a UK private assessment and a result from a US lab arrive in three formats, in two units, and in three places. Nobody joins them up for you.
Several tools try to. Apple Health Records pulls results from participating institutions in the countries where it operates. Guava Health connects to US patient portals. KeepMD keeps records, labs and visits in one timeline with PDF, CSV and FHIR export on its paid plan. Longetic reads a lab report you upload as a PDF or a photo, from any laboratory in any country, charts each biomarker over time and keeps visits, diagnoses and medications in the same searchable history. As a disclosure, Longetic is our product, so weigh that mention accordingly. It is iPhone only, it does not read every layout and language, and it does not interpret a result or tell you what to do about it.
If you are deciding whether a given test is worth repeating this year, the useful thing to take into the room is the last value and the date it was taken, which is one of the seven sections of a doctor-ready summary. That conversation goes differently when the interval is a fact rather than a guess.
