According to the Center for Disease Prevention and Control (SPKC), referenced by the National Health Service (NVD), each adult resident of Latvia has an average of three risk factors for cardiovascular diseases. The most common of these are smoking, arterial hypertension, that is, high blood pressure, and elevated cholesterol levels in the blood. The NVD reminds that free preventive examinations are available to adult residents of certain ages, including a check-up with a family doctor, heart health assessment, diabetes screening, and screening for four types of cancer. These examinations are funded by the state and conducted outside the general queue for appointments. ## Free Preventive Examination with a Family Doctor If a person has not visited their family doctor for any illness within the year, they can undergo a state-funded preventive examination. To do this, it is necessary to contact the practice of their family doctor and arrange a visit time. No co-payment from the patient is required for the preventive examination. During the appointment, the family doctor listens to the patient's complaints, assesses their health status, and, if necessary, measures blood pressure and pulse, checks body weight and height, examines the condition of the skin and mucous membranes, listens to the heart and lungs, and also inspects and palpates the lymph nodes in the neck, armpits, and groin area. The doctor may also assess the patient's vision and hearing, mental, sensory, motor, and neurological functions, thyroid condition, and perform abdominal palpation. Based on the examination results, the family doctor may recommend additional tests or consultations with specialists, as well as provide recommendations on what to pay attention to in the future considering the patient's health condition. ## Heart Check for Free at Certain Ages Patients aged **40, 45, 50, 55, 60, and 65** will also have their cardiovascular disease risk assessed using the SCORE method during their preventive examination with a family doctor. If necessary, the doctor reviews the history of cardiovascular diseases and smoking, measures blood pressure, determines body mass index, levels of total cholesterol, low-density and high-density cholesterol, and triglycerides, listens to the heart and carotid arteries, and evaluates the electrocardiogram. ## Who Gets Free Blood Sugar Checks During the annual preventive examination with a family doctor, the state covers the cost of determining fasting plasma glucose levels for certain patients without diabetes risk factors. This examination is conducted for patients aged **40 years**, and for individuals **aged 45 to 72 — once every three years**. If the family doctor determines that the patient is overweight — with a body mass index of at least 25 kg/m² — and there is at least one other risk factor or previously identified borderline hyperglycemia, fasting plasma glucose levels must be determined annually. ## The State Covers Screening for Four Types of Cancer The NVD preventive examination program includes screening for **cervical, breast, bowel, and prostate cancer**. The NVD emphasizes that precancerous changes often do not cause any complaints or symptoms. Therefore, a person may not even suspect they have the disease. Regular screening allows for early detection of the disease and timely initiation of treatment. For cervical and breast cancer screening, women of certain ages are sent invitation letters, which also serve as referrals for the service. The visit to the doctor and preventive examination are fully funded by the state. ## Cervical Cancer: When Invitations Are Sent Women aged **25 to 29 years** receive an invitation for cervical cancer screening every three years, while women **aged 30 to 70 years — every five years**. The NVD explains that a new and more effective screening method — the human papillomavirus (HPV) test — was introduced in 2025. If the result is negative, the next screening is scheduled for five years later, as the risk of developing cancer during this period is minimal. ## Breast Cancer: Every Two Years An invitation for breast cancer screening is sent every two years to women aged **50 to 68 years**. Letters are sent approximately three months after the birthday to the declared residence address or to the email address on the *Latvija.gov.lv* portal, if such an address has been created. ## Bowel Cancer: Screening for Women and Men The state-funded preventive examination for bowel cancer is recommended every **two years for women and men aged 50 to 74 years**. To do this, it is necessary to contact the family doctor's practice, where the patient will be provided with a kit to conduct a test for hidden blood in the stool. The test is performed at home based on a sample after one bowel movement, after which it must be delivered to the family doctor's practice or the nearest branch of "Centrālā laboratorija" for results. There are no dietary restrictions required before conducting the new type of test. Bowel cancer may initially present as benign growths — polyps, which can develop into malignant disease if left untreated. Such changes typically occur over **10–20 years**. Polyps and early-stage bowel cancer usually do not cause symptoms or complaints. According to the SPKC, about half of patients are diagnosed late. ## Prostate Cancer: Who Is Entitled to Free Screening Preventive examination for prostate cancer every two years is provided for all men aged **50 to 75 years**. Men aged **45 to 50 years** are also recommended to undergo it every two years if prostate cancer has been diagnosed in any of their blood relatives. To undergo the examination, it is necessary to contact the family doctor's practice. During the visit, the doctor will issue a referral for a blood test to determine the level of prostate-specific antigen — **PSA** — in the laboratory. Prostate cancer is the most common tumor of the genitourinary system in men and the second most common malignant neoplasm in men over 40 years of age. The risk of the disease doubles if prostate cancer has been present in any relatives. If two close relatives have had it, the risk increases up to nine times. ## Don’t Wait Until Something Hurts Many dangerous diseases can develop for a long time without noticeable symptoms. Therefore, free preventive examinations provide an opportunity to detect a problem before serious complaints arise. Depending on age, residents of Latvia have access to state-funded checks for cardiovascular risk and blood sugar levels, as well as screening for four types of cancer. The main thing is not to postpone prevention and to take advantage of the examinations that are already funded by the state in a timely manner.
