Health Screenings Every Adult Over 40 in Nepal Should Have
Age 40 is the clinically significant threshold at which the burden of non-communicable disease in Nepal begins to accelerate. Hypertension, type 2 diabetes, thyroid disease, cardiovascular disease, and several cancers all increase sharply in incidence from the fifth decade onward. Screening — testing before symptoms appear — allows early intervention that prevents death, disability, and costly late-stage treatment.
Why Is Age 40 the Most Important Health Turning Point?
Before age 40, most people in Nepal are affected primarily by infectious disease and reproductive health issues. After age 40, the risk profile shifts dramatically toward chronic, lifestyle-related conditions. Nepal’s own burden of disease data confirms that stroke, ischaemic heart disease, diabetes, and COPD are the leading causes of premature death and disability in mid-adult life.
The economic logic of screening is unambiguous: treating hypertension costs far less than treating its consequences — stroke rehabilitation, dialysis for hypertensive kidney disease, or cardiac surgery. The same applies to diabetes, where early diagnosis and prediabetes intervention can prevent blindness, amputation, and renal failure that develop over decades of uncontrolled disease.
What Are the 10 Essential Screenings for Adults Over 40 in Nepal?
1. Blood Pressure Measurement
Who: Every adult over 40, every year.
Hypertension is symptomless in most people until it causes a stroke or heart attack. Nepal’s prevalence exceeds 30% in adults. A two-minute blood pressure measurement at A&B during any visit can initiate a life-saving treatment.
2. Fasting Blood Glucose and HbA1c
Who: Every adult over 40; earlier if BMI above 23, family history, or other risk factors.
Frequency: Annually once risk factors are present; every 3 years if normal with no risk factors.
The HbA1c test requires no fasting and reflects glucose control over 2–3 months. It identifies both prediabetes and diabetes.
3. Lipid Profile (Cholesterol Panel)
Who: All adults over 40.
Frequency: Every 5 years if normal with no risk factors; annually if diabetic, hypertensive, or with established cardiovascular disease.
The lipid profile measures total cholesterol, HDL, LDL, and triglycerides. High LDL and low HDL significantly increase heart attack and stroke risk — and are often asymptomatic until an event occurs.
4. BMI and Waist Circumference
Who: All adults.
BMI above 23 kg/m² in South Asians indicates overweight. However, waist circumference is a better predictor of metabolic risk than BMI alone. A waist above 90 cm in men and 80 cm in women (South Asian criteria) indicates central obesity and increased cardiometabolic risk even at normal BMI.
5. Thyroid Stimulating Hormone (TSH)
Who: Women over 35 (higher prevalence); men over 50.
Frequency: Every 3–5 years if normal.
Hypothyroidism (underactive thyroid) in Nepal is common, particularly in women, and is frequently misattributed to tiredness, weight gain, dry skin, and low mood. A single TSH test identifies it. Hyperthyroidism (overactive thyroid) — more common in iodine-deficient regions — causes weight loss, palpitations, and anxiety.
6. CBC (Complete Blood Count)
Who: All adults over 40; more frequently for women, vegetarians, and those with fatigue.
Frequency: Annually as part of health check-up.
Anaemia is the most prevalent nutritional deficiency in Nepal. A CBC identifies iron deficiency anaemia, B12 deficiency, and blood disorders. It also screens for lymphoma and leukaemia if white cell or platelet counts are markedly abnormal.
7. Vision Assessment
Who: All adults over 40.
Frequency: Every 2 years; annually if diabetic (diabetic retinopathy) or hypertensive.
Presbyopia (difficulty reading) is universal by age 45 but is often the first time adults attend any health service. This visit should be combined with a screen for glaucoma (elevated intraocular pressure), which is asymptomatic until advanced. Diabetic and hypertensive patients need annual fundoscopy.
8. Dental Check-Up
Who: All adults.
Frequency: Every 6–12 months.
Periodontal (gum) disease is an independent risk factor for cardiovascular disease and worsens glycaemic control in diabetes. Oral cancer screening should be included in adults over 40 who use tobacco or betel nut — both highly prevalent in Nepal’s population.
9. Sex-Specific Cancer Screenings
Men — Prostate Specific Antigen (PSA):
PSA testing is recommended for discussion with a doctor from age 50, or age 45 with a family history of prostate cancer. PSA is not a perfect test — it can be elevated by benign prostate enlargement (BPH) — but it provides a useful baseline.
Women — Cervical Cancer Screening:
Cervical cancer is the most common cancer in Nepali women. The WHO recommends screening starting at age 25 (or earlier if sexually active). Methods available include VIA (Visual Inspection with Acetic Acid), Pap smear, and HPV DNA testing. A&B coordinates referral for cervical screening. HPV vaccination is recommended for girls 9–14 years (primary prevention) and unvaccinated women up to age 45 (catch-up).
Women — Breast Health:
Breast self-examination awareness should be reinforced at every health check. Clinical breast examination by a doctor is part of A&B’s women’s health check-up. Mammography is recommended from age 40 (annually) to 50–74 (every 2 years) — coordinate referral through A&B.
10. Colon Cancer Screening (From Age 50)
Colorectal cancer incidence is rising in Nepal. Faecal occult blood test (FOBT) from age 50 is the practical first-line screening tool in Nepal, where colonoscopy access is limited. FOBT should be done annually. Any positive result warrants colonoscopy referral.
Cancer Screening in the Nepal Context
Three cancers warrant specific attention for the Pokhara population:
Cervical cancer: The leading cancer in Nepali women. Highly preventable with HPV vaccination and screening. A&B coordinates referral for Pap smear and VIA testing.
Oral cancer: Nepal has among the highest rates of tobacco and betel nut use in Asia. Any ulcer or white/red patch in the mouth present for more than three weeks in a tobacco user must be evaluated.
Lung cancer: Tobacco smoking is the primary cause. Chest X-ray annually in heavy smokers over 50 is the currently practicable screening in Nepal’s setting.
How to Organise Your Health Records
Maintaining your own health record file prevents unnecessary repeat testing, provides comparison values over time, and ensures continuity of care when you see different doctors. A practical personal health file includes: latest blood test reports (dated), ECG trace, imaging reports, medication list with doses, vaccination record, and blood pressure log if you monitor at home.
Cost of Full Screening at A&B
The cost of a comprehensive health screening package at A&B is available on request. Packages are priced to make annual check-ups accessible. ECHS beneficiaries receive cashless screening for approved investigations. Call +977 061-412512 for current package pricing.
Book Your Over-40 Health Screening at A&B International Hospital
A&B International Hospital
Pokhara-02, Bindhyaabasini Way to Sarangkot
Phone: +977 061-412512
Complete age-appropriate health screening packages with same-day results and doctor consultation. ECHS cashless screening available. Early detection saves lives.
