Prevention: Are regular health check-ups worthwhile?

Photo of a waiting room
PantherMedia / Cathy Yeulet

Lots of people who want to stay healthy go for regular general health check-ups. But the benefits of these check-ups shouldn’t be overestimated. The research done so far hasn't shown that regular general health check-ups prevent illness in healthy people or increase their life expectancy.

In Germany, everyone who is 35 or older and has statutory health insurance is entitled to go for a general health check-up every three years. You can have this check-up once between the ages of 18 and 35 too. After you reach the age of 35, you can also be tested for hepatitis B and hepatitis C once as part of the check-up. The general check-up includes:

  • Medical history (anamnesis): You discuss your medical history with your doctor to determine whether any medical conditions run in your family or whether you have any other risk factors.
  • Physical examination: The doctor will look at or listen to various parts of your body, or examine them by touch. This includes listening to your heart and lungs and testing your reflexes and flexibility.
  • Blood test: A blood sample will be taken to measure your total and blood sugar levels.
  • Rapid urine test: This test measures the levels of various substances that could be a sign of bacterial infections, kidney diseases or diabetes.
  • Vaccination check: Your current status is checked.
  • Health advice

Health check-ups are designed to detect any risk factors and illnesses as early as possible – before they start to cause problems.

Why the effectiveness of screening needs to be tested in studies

Examinations like this general health check-up only make medical sense if they actually help to improve people's health. This is the case, for example, if they prevent illnesses and their effects. But that's often more difficult than it may at first appear. Detecting risk factors alone isn’t enough. Preventive measures like making permanent lifestyle changes or taking blood-pressure-lowering medications also need to be followed through on. But most importantly of all, these steps have to be effective. Because there’s no guarantee of that, it's important to carry out research on the benefits of health check-ups.

Every examination also has disadvantages too. For example, people may sometimes be wrongly diagnosed with something. Overdiagnosis can be especially problematic. An overdiagnosis is where something unusual is discovered, and then monitored or treated by a doctor, although it would never have caused any health problems.

For instance, many people's are slightly above the level considered to be normal. That doesn’t automatically mean that they have a higher-than-average risk of cardiovascular disease. But finding “abnormal” levels of something can cause people to worry unnecessarily. Sometimes people also put up with the disadvantages of a treatment, such as the side effects of a medication, even though the medication doesn’t help their health. Good-quality research is also needed in order to find out whether results in these types of disadvantages.

Results of studies involving over 250,000 participants

Danish researchers from the international looked into the advantages and disadvantages of general health check-ups. They wanted to find out whether such check-ups increase life expectancy and prevent deaths caused by cardiovascular diseases.

The researchers analyzed the results of 15 randomized controlled trials (RCTs) involving more than 250,000 participants. RCTs are a type of study that provide the most reliable results about the benefits and harms of medical treatments.

The check-ups included regular assessments of risk factors for cardiovascular diseases. The types of diagnostic tests and procedures that were used differed slightly from study to study. They generally included several of the following, though:

  • Discussion of medical conditions in the family
  • General physical examination
  • Height and weight measurement
  • Blood test (blood sugar and cholesterol)
  • Urine test
  • Blood pressure measurement
  • Measurement of the electrical activity of the heart (electrocardiogram, also known as an ECG)

Some studies used other diagnostic tools too, for example a lung function test. Many of the diagnostic tests and procedures used in the studies are also used in the general health check-up that is offered by statutory health insurers in Germany. The participants were mainly aged between 30 and 60. In most of the trials, the check-ups took place either annually or every two to four years. But they were not always carried out for the entire length of the study.

The researchers monitored the participants for up to 30 years to see, for instance, whether they were still alive or had died of a cardiovascular disease.

No effect on life expectancy or cardiovascular disease

The studies showed that the check-ups usually didn’t have the expected results. Some studies found that people who were invited to have a health check-up were somewhat more likely to be diagnosed with something. For instance, they were more often diagnosed with high blood pressure or high cholesterol.

But the general check-ups still weren’t shown to have any benefits and people who were invited to have check-ups didn’t live any longer. They didn't develop or die from cardiovascular disease less often than people who were not invited for a check-up.

There may be a number of reasons for this disappointing outcome. One reason is that family doctors know their patients well anyway, examine them regularly and suggest treatments if necessary, perhaps because they are in a particular risk group. Another possible reason is that truly serious problems may be detected early enough in other ways so routine check-ups have hardly any benefits. Check-ups also often detect only slightly increased cholesterol or blood pressure levels that don’t necessarily cause health problems and don’t need to be treated immediately.

Krogsbøll LT, Jørgensen KJ, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev 2019; (1): CD009009.

Scheidt-Nave C, Du Y, Knopf H et al. Verbreitung von Fettstoffwechselstörungen bei Erwachsenen in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsbl 2013; 5/6: 661-667.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on February 10, 2022
Next planned update: 2025

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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