Annual Physical Assessment Recommendations for Adults

Core Physical Examination Components

The American College of Physicians recommends blood pressure measurement annually to screen for hypertension in adults, particularly those with risk factors for cardiovascular disease 1, 2
A complete physical examination with calculation of BMI and measurement of waist circumference is recommended to assess for central obesity, which is an independent risk factor for mortality, as suggested by the American Heart Association 1
Evaluation of skin for concerning lesions and examination of thyroid is recommended as part of a comprehensive physical examination, according to the Infectious Diseases Society of America 2
Digital rectal examination may be considered in adults, though this is somewhat controversial, as stated by the American Urological Association 2, 3

Fasting glucose testing is recommended to screen for diabetes, particularly important in patients with overweight or obesity, as suggested by the American Diabetes Association 1
Fasting lipid profile (total cholesterol, LDL, HDL, triglycerides) is recommended to assess cardiovascular risk, according to the American College of Cardiology 1, 2
Thyroid function tests may be considered as part of basic laboratory evaluation, as recommended by the American Thyroid Association 1

The American Cancer Society recommends no routine prostate cancer screening at age 43, as PSA testing is typically initiated at age 45-50 years after appropriate counseling on benefits and risks, as stated by the National Comprehensive Cancer Network 4
Colonoscopy is not yet indicated (typically begins at age 45-50 years) unless there is a strong family history of colorectal cancer, as recommended by the American Gastroenterological Association 2, 3

The Centers for Disease Control and Prevention recommend reviewing immunization status and updating as needed, particularly for adults with certain risk factors 2
Annual influenza vaccination should be offered to all adults, as recommended by the American Academy of Family Physicians 3
Ensuring tetanus-diphtheria vaccination is current (every 10 years) is recommended, according to the Advisory Committee on Immunization Practices 2

Calculating 10-year cardiovascular risk using an appropriate risk calculator is recommended, as suggested by the American College of Cardiology 1

The American Heart Association recommends providing education on diet, physical activity, weight management, smoking cessation (if applicable), and alcohol use, as part of comprehensive lifestyle counseling 1, 2
Discussing sleep patterns and screening for sleep disorders if indicated is recommended, according to the American Academy of Sleep Medicine 1
Addressing mental health concerns and screening for depression is recommended, as stated by the American Psychiatric Association 3

The National Comprehensive Cancer Network recommends that if the patient has a family history of certain cancers or genetic conditions, additional screening may be warranted 6, 7
For patients with obesity (BMI ≥30), considering a more comprehensive evaluation of obesity-related comorbidities is recommended, as suggested by the American Association of Clinical Endocrinologists 1
Screening for sexually transmitted infections should be performed based on risk factors, according to the Centers for Disease Control and Prevention 2, 3

Failing to consider family history when determining appropriate cancer screening schedules is a common pitfall, as stated by the American Cancer Society 7, 2
Overlooking mental health assessment as part of the comprehensive evaluation is a common pitfall, according to the American Psychiatric Association 3
Not addressing lifestyle factors that contribute to chronic disease risk is a common pitfall, as recommended by the American Heart Association 1