Comprehensive early disease detection tests for full body screening.

Ranked on: for each organ system, the test with the strongest evidence that finding its commonest serious disease early improves an outcome; systems are ordered by how much premature death and disability their diseases cause. Grades apply to the test for that system, in the population it is indicated for.

1. 01

   Heart and blood vessels — ApoB, lipoprotein(a), blood pressure, calcium score at intermediate risk

   GRADE A·EstablishedThe system that kills most; screened by blood and a cuff

   ApoB yearly and Lp(a) once quantify atherogenic risk decades before an event; blood pressure is the single most consequential screen in medicine; a coronary calcium score reclassifies intermediate risk to guide a statin decision. Each feeds treatment with randomised mortality evidence. No imaging beyond the calcium score is needed in the asymptomatic.

2. 02

   Metabolism — HbA1c, fasting glucose and insulin, waist circumference

   GRADE A·EstablishedDiabetes is detectable years before it is diabetes

   Fasting insulin rises first, HbA1c later; a waist measurement adds the visceral-fat signal that drives both. Yearly from forty or earlier with risk. The treatment at the early stage is lifestyle, and it works best exactly then.

3. 03

   Kidneys — eGFR and urine albumin-to-creatinine ratio

   GRADE A·EstablishedSilent until late; slowed by early treatment

   Urine albumin detects damage before eGFR falls; both are cheap. Chronic kidney disease is slowed by blood-pressure control and SGLT2 inhibitors, and the earlier the better. Yearly with hypertension or diabetes.

4. 04

   Liver — ALT, AST, GGT

   GRADE A·EstablishedFatty liver is common, silent and reversible early

   A raised ALT is often the first sign of metabolic fatty liver disease; GGT flags alcohol. Confirmed elevation leads to imaging and a hepatitis screen. Yearly, with the panel.

5. 05

   Blood — full blood count and ferritin

   GRADE A·EstablishedAnaemia, iron deficiency, hidden bleeding, blood cancers

   The blood count catches anaemia and the white-cell and platelet abnormalities of marrow disease; ferritin finds iron deficiency before anaemia and, in men and post-menopausal women, is a reason to look for gastrointestinal blood loss. Yearly.

6. 06

   Thyroid — TSH

   GRADE B·PromisingCommon, silent, cheap, treatable

   Every two to three years, yearly over sixty, and with any suggestive symptom. Both under- and over-activity are treated with generic medicines.

7. 07

   Colon — colonoscopy, or an approved stool-DNA or blood-based test

   GRADE A·EstablishedFinds and removes the precursor; mortality evidence

   Colonoscopy on the guideline schedule detects and removes precancerous polyps; stool-DNA and blood-based tests are less sensitive for precursors but proven enough for people who will not have a colonoscopy. A positive on either leads to colonoscopy.

8. 08

   Breast — mammography in the guideline range

   GRADE B·PromisingProven benefit with quantified harms

   Randomised evidence of reduced breast-cancer mortality; false positives and overdiagnosis are measured and real. Supplemental imaging for dense breasts is a discussion, not a default.

9. 09

   Cervix — HPV testing or cytology

   GRADE A·EstablishedOne of the great successes of screening

   Cervical screening detects precancerous change and has reduced cervical-cancer incidence and mortality wherever it is delivered on schedule. HPV-based testing extends the interval.

10. 10

    Lungs — low-dose CT, heavy smokers only

    GRADE A·EstablishedLife-saving in one population; harmful outside it

    Annual low-dose CT reduces lung-cancer mortality in people with a heavy smoking history; in never-smokers it generates false positives and overdiagnosis without the benefit. The population is the whole decision.

11. 11

    Skin — full-skin examination

    GRADE B·PromisingCheap, low-harm, and early melanoma detection changes survival

    Yearly with significant sun exposure or a history of skin cancer; sooner for any changing lesion. The full-body screen that genuinely involves the full body, done by eye.

12. 12

    Prostate — PSA, after a conversation

    GRADE C·EarlyFinds cancer early, and cancers that never matter

    Modest reduction in prostate-cancer deaths in trials against many false positives, biopsies and overdiagnosed cancers. From fifty after an informed conversation, earlier with family history or African ancestry; a rising trend matters more than one value; MRI before biopsy.

13. 13

    Brain — cognitive assessment when symptoms arise; p-tau217 for people who have them

    GRADE C·EarlyThe accurate test exists; the reason to screen the well does not, yet

    Plasma p-tau217 matches amyloid PET and guides diagnosis and treatment eligibility in symptomatic people. In the cognitively well it finds pathology years early with no treatment that changes the course enough to justify it. Screen for symptoms; test the symptomatic.

14. 14

    Whole-body MRI as full-body screening

    GRADE D·Insufficient or unsafeCovers every system worse than the system's own test

    Non-contrast screening protocols are less sensitive than targeted imaging for any specific condition, image nothing about the blood, metabolism or vessels that the panel does not do better, and produce a critical or indeterminate finding in roughly a third of healthy adults with no evidence of benefit. It is one test wearing the name of thirteen.

15. 15

    Multi-cancer blood tests as cancer screening

    GRADE D·Insufficient or unsafeCovers cancer worse than the organ-specific screens

    Detects about 17% of stage I cancers, missed its randomised endpoint, and does not replace colorectal, breast, cervical or lung screening for any of the cancers those detect. A supplement to the list at best, and not yet an evidence-based one.