Check-up 35 vs. YEARS Core

Two Paths to Prevention – But Not the Same Goal

Prevention saves lives. Today, nobody seriously doubts that (Krogsbøll et al., 2012). Heart attacks, diabetes, certain cancers – many of these conditions don’t develop overnight. They are the result of long, silent processes. The good news: if you look early enough, you can often intervene. That’s why preventive health checks exist, such as the “Check-up 35” offered by family doctors in Germany. What many don’t realize: not all prevention is equally thorough. There are big differences – structural, content-related, and especially diagnostic.

This article compares the GP “Check-up 35” with the YEARS Core program. Not in terms of right or wrong. But with a clear question: How much insight do I really want into my body?

What the Check-up 35 Can Do – and Why It Matters

The Check-up 35 is a free service provided by German statutory health insurance. From the age of 35, insured individuals are entitled to a general health check every three years. Its purpose is to detect chronic conditions such as diabetes, cardiovascular disease, or kidney disease at an early stage – before symptoms appear. A sensible approach: these widespread diseases often go unnoticed for years but cause enormous personal and economic harm if left untreated.

The exam includes a medical history, blood pressure measurement, basic lab work (e.g., cholesterol, glucose), a urine test, and a consultation. Optional additions include skin cancer screening or tests for hepatitis B and C. In this way, the Check-up 35 provides essential baseline data about a person’s health – systematic, efficient, and for many, the first real entry point into preventive medicine.

But what about the risks this check can’t detect?

Despite its relevance, the Check-up 35 remains a minimal offer. No imaging. No stress ECG. No ultrasound. No in-depth lab analysis on inflammation, organ function, or detailed metabolic profiles. No neurocognitive screening, no functional diagnostics, no assessment of physical performance.

And when it comes to conditions like metabolic syndrome, diabetes, and cardiovascular disease, there are many validated biomarkers with practical relevance that still haven’t been integrated into the GP check. Lipoprotein(a) [Lp(a)] is just one example (Tsimikas et al., 2018). Others include fasting insulin or ApoB (Marston et al., 2022).

The reasons are obvious: cost structures and systemic inertia. The healthcare system pursues a different goal than individual optimization. It’s about broad access, not maximum depth. About early detection at the population level, not high-end personalized prevention. For many people, that’s enough. Others want more.

YEARS Core: From Checking Off Boxes to Real Understanding

This is where YEARS Core comes in. It was designed for people who want to know what is really happening inside their body. Not because they’re sick – but because they want to avoid becoming sick. Because they know: health isn’t binary, it’s a continuum. And the better you know your starting point, the better you can manage it.

YEARS Core combines advanced imaging with more than 25 functional tests and analysis of over 80 key biomarkers. This includes liver and kidney function, cardiovascular risk markers, inflammation, glucose metabolism (including an oral glucose tolerance test) (The Diabetes Prevention Program Research Group, 1999), micronutrients, and many other parameters. Added to this are AI-based skin cancer screening, neurocognitive testing (including dementia prevention), 3D body scanning, and sports science diagnostics – from VO2max (Mandsager et al., 2018) and HRV to strength balance (Bohannon, 2019). In short: broader, deeper, and more precise than anything you’d get at a GP’s office.

All of it takes place in a single day – no waiting rooms, no referrals, no data gaps. Results are shared in a same-day medical debrief. Two weeks later, you receive a comprehensive health report and a physician-designed prevention plan: individual, practical, evidence-based.

Two Concepts, Two Perspectives

Does that make the Check-up 35 redundant? Not at all. It serves a vital purpose, and we shouldn’t downplay it. It provides basic preventive care for millions and helps detect major conditions like diabetes or hypertension early. For many GPs, it’s also the moment they first introduce their patients to prevention as a topic. That’s valuable – especially in a system that often only reacts when something is already broken.

But: anyone who takes prevention seriously eventually reaches the limits of standardized protocols. People who are healthy – and want to stay that way long term – need more than a “within normal range” statement. They need data that goes deeper. Diagnostics that reveal not just what is already obvious, but what is only starting to develop. And structured guidance that encourages proactive action rather than waiting for symptoms.

Conclusion: Responsibility Starts With Understanding

The real question isn’t whether the Check-up 35 or YEARS Core is “better.” The real question is: How much do I want to know about my health – and how early?

One path is systemic. The other is individual. Both are valid. But they don’t pursue the same goal.

YEARS Core isn’t a substitute for primary care. It’s the complement – for those ready to invest more: time, attention, and a commitment to real prevention.

Because anyone who truly wants to understand their health must look earlier, deeper, and more systematically (Estruch et al., 2013). That’s exactly what we’re here for.

Note: And what about people under 35? In that age group, statutory insurance covers the check-up only once. Yet issues like chronic inflammation, brain fog, fatigue, recurrent infections, and cardiovascular risk are highly relevant between 18 and 34 – and often more than once.