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Why Annual Check-ups Matter More After 40

By Dr Setlogelo · 16 May 2026 · 5 min read

A Black female GP in conversation with a mature patient during a routine consultation

You feel fine. That is exactly the problem.

The truth most doctors will tell you, if you give them the time, is that the conditions that quietly shorten South African lives almost never announce themselves. High blood pressure does not hurt. Early diabetes does not hurt. Most cancers, in their earliest stages, do not hurt. By the time something hurts enough to send you to a doctor, the work of fixing it has often become far harder than the work of preventing it would have been.

This is the case for the annual check-up after 40. Not because something is wrong. Because something might be, and you would rather find it now.

The numbers we cannot ignore

In South Africa, hypertension affects somewhere between 38 and 48 percent of adults (Reddy et al., 2021). That is roughly one in two of us. More worrying still, a national survey found that around 91 percent of people with high blood pressure were either unaware they had it, or aware but not adequately treated (Stokes et al., 2017). This is why we call it the silent killer. People walk around for years with arteries quietly under siege, often only finding out when something serious happens.

Diabetes has now become the leading non-communicable disease cause of death in our country (Stats SA, 2024). Over the past two decades, deaths from major non-communicable diseases in South Africa have climbed by almost 59 percent. We are not in a situation where we can afford to wait until we feel unwell.

What an annual check-up actually involves

This is not a long ordeal. A proper annual visit for someone over 40 takes about 30 to 45 minutes. We sit down. We talk about your life. We measure a few things. We send for a few tests. Then we have a conversation about what the results mean for you.

The basics include blood pressure, weight, waist measurement, and a general clinical examination. We will usually request a fasting blood test to check your blood sugar, cholesterol profile, and kidney function. The US Preventive Services Task Force recommends cholesterol screening at least every five years for adults aged 40 to 75 (USPSTF, 2022), and many South African doctors test annually given our local risk profile.

Cancer screening, where the rules are clear

For women, the Cancer Association of South Africa recommends an annual mammogram from age 40, with the option to move to every two years from age 55 (CANSA, 2024). This is one of the most useful and least invasive screening tests we have. Cervical cancer screening also continues into your 40s and beyond, following the schedule your doctor has set based on past results.

For men, the prostate is the conversation. CANSA recommends an annual PSA blood test and clinical examination from age 50, with earlier screening from age 40 to 45 for men at higher risk, including Black African men and men with a family history of prostate cancer (CANSA, 2024). If you are over 40 and have not had this conversation, please come and have it.

For both men and women, colorectal cancer screening becomes important from 50, generally through a colonoscopy every ten years or stool-based testing more often. Family history can shift that age earlier. None of these tests are pleasant to discuss over a braai. All of them have saved lives.

The hidden value of sitting down with your GP

Some of the most useful things that happen in an annual check-up are not on the test results. They are in the conversation.

How is your sleep? Are you carrying stress that is not letting up? Are you drinking more than you used to? Is your relationship with food healthy, or has it shifted? How is your mood? When did you last do something that felt joyful for its own sake?

These are not soft questions. They are clinical ones. Stress and sleep affect your blood pressure. Alcohol affects your liver, your weight, and your blood sugar. Depression after 40 is more common than most of us realise, and is one of the most under-treated conditions in our country. Your GP is one of the few people in your life who can pull these threads together and notice what each of them is pulling on.

A practical word about cost

Annual check-ups feel like an expense. We understand. Many South Africans either pay out of pocket or rely on medical aid plans that cover specific tests but not others. The cost calculation is worth thinking about honestly. The fee for a comprehensive annual visit, including basic blood work, is far less than the cost of treating a single hospital admission for an unmanaged condition. It is far less than the cost of dialysis, or a stent, or chemotherapy. Most of all, it is far less than the cost to your family of losing you early.

If you are on medical aid, many plans cover annual wellness benefits in full. Use them. They are there for exactly this reason.

What to do this month

If you are over 40 and have not had a proper check-up in the past 12 months, please make an appointment. Bring any past test results you have. Write down any small concerns you have been carrying around, even if they feel silly. Ask the questions.

Dr Setlogelo and the team at Kelebogile Medical Centre have a particular focus on preventive care, because we believe the best moment to make a difference for your health is long before something has gone wrong. Booking an annual visit is one of the simplest, kindest things you can do for yourself, and for the people who depend on you.

You feel fine. Let us make sure of it.

References

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