Don’t rely on generic health check packages to prevent disease; instead, get the evidence‑based screenings appropriate for your age and gender.

18. Don’t rely on generic health check packages to prevent disease; instead, get the evidence‑based screenings appropriate for your age and gender.

Cost: There’s no cost at all; you even save hundreds to thousands of yuan each year by avoiding these packages. The trade‑off is simply remembering which tests you need and how often to get them.

In plain terms: People who regularly undergo generic health checks have the same mortality rates as those who don’t, including deaths from cardiovascular disease and cancer. It’s enough to get the evidence‑based screenings that match your age and gender. Individuals over 35 can have their blood pressure measured for free once a year, and those 65 or older receive a free annual health check.

Benefit: The 2019 update of a Cochrane systematic review included 17 randomized controlled trials. When looking at overall mortality, data from 11 of those trials involving 233,298 participants and 21,535 deaths showed no difference: the RR was 1.00 (95% CI 0.97–1.03). For deaths from cardiovascular disease, nine trials with 170,227 participants and 6,237 deaths yielded an RR of 1.05 (95% CI 0.94–1.16); for cancer deaths, eight trials with 139,290 participants and 3,663 deaths gave an RR of 1.01 (95% CI 0.92–1.12). In each case there was no meaningful difference. The authors concluded that generic health checks are unlikely to provide any real benefit. As part of the national basic public health service, residents aged 35 and older can have their blood pressure measured for free each year, while those 65 and older receive a free annual physical exam. This exam includes a physical examination, complete blood count, urinalysis, fasting blood glucose, electrocardiogram, and tests for liver function (AST, ALT, total bilirubin), kidney function (serum creatinine, blood urea), and lipid profile (total cholesterol, triglycerides, LDL‑C, HDL‑C). An abdominal ultrasound of the liver, gallbladder, pancreas, and spleen is also offered nationwide.

Evidence grade: A

Sources: Krogsbøll LT, Jørgensen KJ, Gøtzsche PC (2019). General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database of Systematic Reviews, 1, CD009009. <https://doi.org/10.1002/14651858.CD009009.pub3>; National Health and Family Planning Commission (2017). National Basic Public Health Service Specifications (Third Edition) (Health Management Services for the Elderly, Health Management Services for Hypertensive Patients). <https://www.nhc.gov.cn/ewebeditor/uploadfile/2017/04/20170417104506514.pdf>

Notes: What we’re discouraging is using annual check‑up packages as a preventive measure; it doesn’t mean you should skip all tests. The free annual blood pressure measurement for those over 35 and the free annual physical for seniors are already part of the national public health program, so there’s no need to pay for them. Get tested for any condition you have a reason to screen for. Information on blood pressure, blood glucose, and hepatitis B can be found in sections 7, 8, and 14 of Chapter 1; breast, cervical, and colorectal cancer screening details appear in sections 17, 18, and 19. Helicobacter pylori testing and low‑dose CT screening are covered in sections 23 and 24. Bone density testing for women over 65 is described in section 39. If you’ve engaged in high‑risk behaviors, follow the guidance in section 31. The recommended ages and intervals for each test are listed there. Feel free to attend any employer‑sponsored or other paid health screenings; the warning applies only to buying full packages or adding extra tests at your own expense. People with chronic diseases, symptoms, or those prescribed tests by a doctor are excluded from this advice — those are medical treatments, not screening. The most commonly offered tests with little or no evidence base are tumor markers and whole‑body imaging; see section 7 for PET‑CT scans and tumor marker panels. For cases of elevated uric acid or silent gallstones, refer to sections 19 and 20 respectively. Finally, note that most of the Cochrane trials were conducted in high‑income countries where healthcare access is easy; this conclusion may not be directly applicable to regions with limited medical resources.