Laboratory Tests for Annual Physical Examinations in Adults

Core Laboratory Tests

• The American Diabetes Association recommends a comprehensive metabolic panel, complete blood count, lipid profile, and hemoglobin A1C as standard laboratory tests for routine annual physical examinations in adults to screen for common conditions and assess overall health status 1
• A complete blood count (CBC) with differential is recommended to screen for anemia, infection, and blood disorders in all adults 1
• A comprehensive metabolic panel (CMP) is recommended to assess kidney function, liver function, and electrolyte balance in all adults 1
• A lipid profile, including total cholesterol, LDL, HDL, and triglycerides, is recommended to assess cardiovascular risk in all adults 1, 2
• Hemoglobin A1C is recommended to screen for diabetes and prediabetes in all adults 1, 2
• Urinalysis with albumin-to-creatinine ratio is recommended to screen for kidney disease and urinary tract infections in all adults 1

Age and Sex-Specific Tests

• Thyroid-stimulating hormone (TSH) is particularly important for women and older adults 1
• Prostate-specific antigen (PSA) is recommended annually in men aged 50+ years (earlier in high-risk men) 3
• Hepatitis B screening is recommended for adults with diabetes under age 60 1

Frequency Recommendations

• Most laboratory tests should be performed annually as part of routine physical examination 1
• Lipid profile may be performed less frequently (every 2 years) in people without dyslipidemia and not on cholesterol-lowering therapy 1
• Vitamin B12 levels should be checked annually in patients taking metformin 1
• Serum potassium levels should be monitored in patients taking ACE inhibitors, ARBs, or diuretics 1

Special Considerations

Diabetes Management

• For patients with diabetes, more frequent monitoring is recommended, including A1C test at least twice yearly if meeting treatment goals, quarterly if therapy has changed or not meeting goals 2, 4
• Annual urine albumin test is recommended for patients with diabetes 4
• Annual lipid profile (or every 2 years if values are in lower-risk levels) is recommended for patients with diabetes 4

Cardiovascular Risk Assessment

• Blood pressure determination should be performed at every visit 1

Common Pitfalls to Avoid

• Failing to consider patient-specific risk factors when determining which tests to order can lead to unnecessary testing 1
• Overlooking the need for more frequent monitoring in patients with chronic conditions or on medications that affect laboratory values can lead to delayed diagnosis or treatment 1