Don’t rely on generic health check packages to prevent disease; instead, get the evidence‑based screenings appropriate for your age and gender

There’s no cost at all; you even save hundreds to thousands of yuan each year by avoiding these packages. The trade‑off is simply remembering which tests you need and how often to get them.

The 2019 update of a Cochrane systematic review included 17 randomized controlled trials. For overall mortality it pooled 11 of them, 233298 participants, and 21535 deaths. The general-check group matched the control group: RR 1.00. RR is relative risk; 1 means the two sides match. 95% CI 0.97–1.03 is the credible range. For cardiovascular death it pooled 9 trials, 170227 people, and 6237 deaths: RR 1.05 (95% CI 0.94–1.16). For cancer death it pooled 8 trials, 139290 people, and 3663 deaths: RR 1.01 (95% CI 0.92–1.12). Neither showed a difference. The authors conclude that “general health checks are unlikely to be beneficial.” The national basic public-health service measures blood pressure free once a year for permanent residents aged 35 and above. It also gives people aged 65 and above one free health check a year. That free check covers physical exam, blood count, urine routine, fasting glucose, and ECG. Liver function: AST, ALT, total bilirubin. Kidney function: serum creatinine, blood urea. Lipids: total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol. Plus abdominal ultrasound of liver, gallbladder, pancreas, and spleen (nationwide).

Krogsbøll LT, Jørgensen KJ, Gøtzsche PC (2019). General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database of Systematic Reviews, 1, CD009009. https://doi.org/10.1002/14651858.CD009009.pub3；国家卫生计生委 (2017). 国家基本公共卫生服务规范（第三版）（老年人健康管理服务、高血压患者健康管理服务）. https://www.nhc.gov.cn/ewebeditor/uploadfile/2017/04/20170417104506514.pdf

What we’re discouraging is using annual check‑up packages as a preventive measure; it doesn’t mean you should skip all tests. The free annual blood pressure measurement for those over 35 and the free annual physical for seniors are already part of the national public health program, so there’s no need to pay for them. Get tested for any condition you have a reason to screen for. Information on blood pressure, blood glucose, and hepatitis B can be found in sections 7, 8, and 14 of Chapter 1; breast, cervical, and colorectal cancer screening details appear in sections 17, 18, and 19. Helicobacter pylori testing and low‑dose CT screening are covered in sections 23 and 24. Bone density testing for women over 65 is described in section 39. If you’ve engaged in high‑risk behaviors, follow the guidance in section 31. The recommended ages and intervals for each test are listed there. Feel free to attend any employer‑sponsored or other paid health screenings; the warning applies only to buying full packages or adding extra tests at your own expense. People with chronic diseases, symptoms, or those prescribed tests by a doctor are excluded from this advice — those are medical treatments, not screening. The most commonly offered tests with little or no evidence base are tumor markers and whole‑body imaging; see section 7 for PET‑CT scans and tumor marker panels. For cases of elevated uric acid or silent gallstones, refer to sections 19 and 20 respectively. Finally, note that most of the Cochrane trials were conducted in high‑income countries where healthcare access is easy; this conclusion may not be directly applicable to regions with limited medical resources.