# Baseline: full text corpus Baseline reports on preventive medicine and the longevity screening industry: what the evidence supports, what the tests detect, and what the programmes cost. Independent, evidence-graded, published in Europe. Method and evidence grades: https://www.baseline-media.com/method/ Independence and funding: https://www.baseline-media.com/ethics/ Index dataset (CC BY 4.0): https://www.baseline-media.com/index-europe/data.json Citation: attribute to Baseline (baseline-media.com) with a link to the article URL. Generated: 2026-09-08 Articles: 20 ================================================================================ # Claim check: “our patients reversed their biological age by six years” URL: https://www.baseline-media.com/articles/claim-check-biological-age-reversed/ Section: Claim Check Evidence grade: D Published: 2026-09-07 | Figures checked: 2026-09-07 A recurring line in longevity clinic marketing, and a clean worked example of how a defensible measurement becomes an indefensible statement. ### Key findings - The claim requires the measurement to be sensitive to real change in one individual. Repeated-measures studies show epigenetic clock estimates move substantially with meals, stress and pollution exposure alone. - No clinic making this claim publishes a within-person confidence interval, which is the single number that would make it checkable. - Regression to the mean produces an apparent improvement in anyone selected for a poor initial result, with no intervention required. - Verdict: unsupported. Not because the intervention did nothing, but because the instrument cannot show whether it did. The claim: a programme reports that its patients reduced their biological age by an average of six years. The measurement is an epigenetic clock. The comparison is before and after. Three problems, in ascending order of severity. ## The instrument moves on its own Epigenetic clocks are technically reproducible, meaning the same sample run twice gives nearly the same answer, and this is the fact clinics cite. It is the wrong fact. Repeated sampling from the same person under ordinary short-term perturbations, including meals, acute stress and pollution exposure, produces substantial fluctuation in the estimate, with most clocks achieving only moderate reliability at best. [1] When the number moves because of when blood was drawn, a before-and-after difference is not evidence about the intervening months. ## Selection guarantees the result Patients who enrol after a discouraging first result are selected for an extreme value. Retest anyone selected that way and the second measurement will on average sit closer to their true value, which is to say better, with no intervention required. This is regression to the mean. It is arithmetic rather than biology, and it is sufficient on its own to produce the headline. Avoiding it requires a control group. Nobody making this claim has one. ## The claim cannot be falsified as stated No clinic publishing this figure publishes the within-person variance of the clock it used, which is the only thing that would let a reader judge whether six years exceeds the noise. Several do not disclose which clock they used at all. [2] ## Verdict Unsupported. Note the scope. This is not a finding that the programme's interventions are worthless, because exercise, sleep and metabolic control have their own evidence independent of any clock. It is a finding that this measurement cannot detect whether they worked, and that presenting it as though it had makes a claim about instrument sensitivity the instrument does not support. What would make it checkable: the clock used, its published within-person confidence interval, standardised draw conditions, and a comparison group that did not receive the intervention. Any clinic with all four should publish them, and we will grade the result again when one does. ### References 1. Biological versus technical reliability of epigenetic clocks and implications for disease prognosis and intervention response. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC13418614/ 2. Belsky DW, et al. DunedinPACE, a DNA methylation biomarker of the pace of aging. eLife. 2022;11:e73420. https://elifesciences.org/articles/73420 ================================================================================ # Neko Health alternatives: what to do about a 100,000-person waitlist URL: https://www.baseline-media.com/articles/neko-health-alternatives/ Section: Comparison Evidence grade: ungraded Published: 2026-09-07 | Figures checked: 2026-09-07 Organisations discussed: Neko Health, Prenuvo, YEARS, Function Health, Superpower, Preventicum Neko built the best-designed cheap health check in Europe and cannot serve the demand. Wait times run six to twelve months. Here is what the alternatives actually replace, and what none of them do. ### Key findings - Neko Health reports a global waitlist above 100,000 people, with wait times of six to twelve months. Its New York clinic opened in September 2026 with 25,000 people already waiting. - Published prices are £299 in the UK and 2,750 SEK in Sweden, for roughly 70 datapoints across an optical skin scan, cardiovascular sensors and a blood panel in about 60 minutes. No imaging. - No alternative matches that price. The nearest options either cost six times more or drop the parts of the product that make it distinctive. - The measurements Neko takes are the ones with decades of outcome evidence behind them. Any replacement that swaps them for imaging is trading well-evidenced tests for a poorly-evidenced one. ### Questions answered **What is the best Neko Health alternative?** It depends which part of Neko you want. For the same well-evidenced measurements at a similar price, a statutory check plus a private lipid and metabolic panel covers most of it for under £150 in most European systems, without the skin scan. For the full-body skin imaging, a dermatologist mole check is the direct clinical equivalent and is often reimbursable. For genuinely more depth, a physician-led day programme such as YEARS Core in Berlin at €1,900 adds spiroergometry, echocardiography and vascular ultrasound, at roughly six times the price. **How long is the Neko Health waitlist?** Neko reports a global waitlist above 100,000 people, with wait times generally quoted at six to twelve months. Its New York clinic opened in September 2026 with 25,000 people already registered. The company operates in Stockholm plus London, Manchester and Birmingham, and has been opening clinics to work through the backlog. **Is Neko Health worth it?** It is the most defensible cheap option in the category, because the things it measures are the things with real outcome trials behind them: blood pressure, lipids, glucose and skin surveillance. It is not a substitute for imaging, it does not include genetics or a cancer blood test, and at £299 with a 60-minute appointment it is priced to be repeated annually rather than to answer a specific question. **Does Neko Health include an MRI?** No, and this is deliberate rather than a limitation of scale. Neko uses a proprietary optical scanner for the skin surface, a cardiovascular sensor array and a blood panel. The company has completed over 100,000 examinations without ever performing an MRI. If anatomical imaging is what you want, Neko is the wrong product at any price. Neko Health has a problem most companies would want: it built something people queue for. The queue is now above 100,000 people, wait times run six to twelve months, and its New York clinic opened in September 2026 with 25,000 already registered. Which means a lot of people who have decided to buy a health check cannot buy this one. Before looking at substitutes, it is worth being precise about what Neko is, because most of the alternatives being marketed replace the wrong part. ## What you are actually queueing for £299 in the UK, 2,750 SEK in Sweden. Roughly 70 datapoints in about 60 minutes: a proprietary optical scanner covering the whole skin surface, a cardiovascular sensor array, and a blood panel. [3] No imaging. Over 100,000 examinations completed and around $1.03bn raised. [4] Two things make it distinctive, and neither is the technology. The first is that the measurements have evidence behind them. Blood pressure, lipids, glucose and skin surveillance are the preventive tests with decades of outcome trials, and Neko declines everything past them. It is the least scientifically adventurous product in the category, and that is its strength. The second is that it is priced to be a habit. Around three-quarters of members prepay their next annual visit. Screening only works if you keep doing it, and almost nothing else in this market is priced for annual repetition by a normal person. An alternative that gives you more resolution but which you will do once, and never again, has not replaced Neko. It has replaced something else. ## The direct substitutes, by what you want from it **If you want the annual measurement habit.** A statutory check plus a private lipid and metabolic panel. In Germany, Check-up 35 is free every three years from 35 and covers blood pressure, fasting glucose, a full lipid panel and urinalysis. Fill the gaps privately with ApoB, HbA1c with fasting insulin, and a one-off Lp(a). That runs well under £150 in most European systems and covers the majority of Neko's medical content. What you lose is the skin scan and the experience. The experience matters more than it sounds, because it is the reason people come back. **If you want the skin imaging.** See a dermatologist. A full-body mole check by a specialist is the direct clinical equivalent, is frequently covered by insurance or a statutory dermatological screening programme, and comes with somebody who can biopsy on the spot. Neko's optical scanner is impressive engineering aimed at doing this at scale and low cost; one-to-one it is not better than a dermatologist looking at you. **If you want blood depth rather than breadth of modality.** Function Health at $499 a year and Superpower at the same price sell 100-plus marker panels with app-based tracking. Both are US-only, neither includes imaging, and both are roughly the same trade Neko makes with more analytes and less hardware. **If the waitlist has pushed you into wanting more.** This is the common outcome, and it is worth being careful about it. Waiting six months tends to convert a £299 intention into a several-thousand-euro one, and that is a different purchase rather than a substitute. A physician-led day programme is the honest version of "more". YEARS Core in Berlin is €1,900 for 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, a cognition test, lung function and body composition, with no imaging, no liquid biopsy and no genetics in that tier. [6] Compared with Neko it adds a cardiopulmonary exercise test, which is the single best-evidenced measurement in this field, plus cardiac and vascular imaging by ultrasound and a physician who reads it all in one sitting. Preventicum in Essen occupies similar ground at a reported €1,400 to €2,000. It costs six times more than Neko, it is a six-hour day rather than an hour, and it is not designed to be repeated annually. Say that to yourself before booking it as a waitlist workaround, because those are three real differences and only one of them is in your favour. ## The substitution that is usually a mistake Whole-body MRI. Prenuvo has European availability now, with a London clinic since 2025 and memberships from $1,199, and it appears in every "Neko alternative" list. It is not one. No randomised trial has shown that whole-body MRI screening reduces mortality in asymptomatic adults. [5] Roughly a third of scanned people leave with a critical or unresolved incidental finding. Trading a panel of well-evidenced measurements for a scan with no outcome evidence is moving in the wrong direction on the thing that matters, even though it feels like an upgrade because it is more expensive and produces pictures. If your specific concern is anatomical, and particularly if you have a family history of a cancer that imaging can find, then imaging is the right purchase. It is just not a Neko replacement, and nobody should end up buying it because a different company had a queue. ## What to do Book the free statutory check now, since it costs nothing and you are waiting anyway. Add the three or four blood markers Neko would have given you plus the ones it would not. See a dermatologist if moles were the reason you booked. Then decide whether you still want Neko in eight months, or whether you have talked yourself into a different product. Both are legitimate. Only one of them is what you originally wanted. ### References 1. Neko Health. Neko Health is opening in New York City, with 25,000 people already waiting. https://www.nekohealth.com/us/en/press/neko-health-is-opening-in-new-york-city 2. Neko: why are 100,000 people queuing up to have this health check? Get the Gloss. https://www.getthegloss.com/health/neko-health-review/ 3. Neko Health review 2026: cost, scan and results. Agewell Guide. https://agewell.guide/clinics/neko-health 4. Full-body scan startup Neko Health scores $700M to break into the US market. Fierce Healthcare. https://www.fiercehealthcare.com/health-tech/full-body-scan-startup-neko-health-scores-700m-break-us-market 5. Kwee RM, Kwee TC. Whole-body MRI for preventive health screening: a systematic review. Journal of Magnetic Resonance Imaging. 2019. https://pubmed.ncbi.nlm.nih.gov/30932247/ 6. YEARS Präventivmedizin, Berlin. Programme pricing and per-tier contents. https://www.years.co/de/was-kostet-ein-longevity-check-up ================================================================================ # The cancer blood test finally has a big trial. Read the sensitivity number twice. URL: https://www.baseline-media.com/articles/mced-blood-tests-after-pathfinder-2/ Section: Evidence Evidence grade: B- Published: 2026-09-04 | Figures checked: 2026-09-07 Organisations discussed: GRAIL, YEARS, Biograph, Fountain Life PATHFINDER 2 put Galleri through 35,878 people and produced the strongest evidence any multi-cancer blood test has. It also showed the test misses about six in ten cancers, and both facts are compatible with it being useful. ### Key findings - In PATHFINDER 2 (n=35,878, adults aged 50 and over with no clinical suspicion of cancer), Galleri showed episode sensitivity of 39.3% across all cancers with specificity of 99.6%, a false positive rate below 0.4%. - For the 12 cancers responsible for roughly two-thirds of US cancer deaths, episode sensitivity was 73.7%. The all-cancer figure and the deadly-cancer figure describe different things and are not interchangeable. - Added to USPSTF grade A and B screening, the test increased cancer detection more than seven-fold. Screening four times detected four times as many cancers as standard of care alone. - The NHS-Galleri randomised trial observed a reduction in stage IV cancers of more than 20%. Cancer signal of origin was predicted with over 90% accuracy. - At 39.3% all-cancer sensitivity the test supplements guideline screening and cannot replace it. A negative result rules out very little. ### Questions answered **How accurate is the Galleri multi-cancer blood test?** In PATHFINDER 2, across 35,878 adults aged 50 and over, episode sensitivity was 39.3% for all cancers with 99.6% specificity. Sensitivity rose to 73.7% for the 12 cancers that cause about two-thirds of US cancer deaths. In plain terms, when it flags a possible cancer it is usually right, and when it says nothing it has missed roughly six in ten cancers overall. **Does a negative Galleri result mean I do not have cancer?** No, and this is the most important thing to understand about the test. At 39.3% all-cancer sensitivity a negative result leaves most cancers undetected. It does not replace mammography, colonoscopy, cervical screening or lung CT for eligible people. Any provider presenting a negative result as broad reassurance is misrepresenting it. **Is a multi-cancer early detection test worth adding to a screening programme?** On current evidence it is the most defensible blood-based addition available, with the caveat that mortality benefit remains unproven. Specificity of 99.6% means few false alarms, signal-of-origin prediction above 90% accuracy makes the workup efficient, and the NHS-Galleri randomised trial showed a stage IV reduction above 20%. No trial has yet shown this translates into fewer cancer deaths. **Which clinics include a multi-cancer blood test?** In the Baseline Index, a liquid biopsy or multi-cancer blood test is included by YEARS in Berlin across all three of its tiers, by Biograph in its $15,000 Black membership but not its $7,500 Core, and by Fountain Life. Prenuvo, Neko Health, Function Health and Superpower do not include one. import Figure from '@/components/Figure.astro'; A multi-cancer early detection test looks for fragments of tumour DNA circulating in blood and, when it finds them, predicts which organ they came from. The category spent five years being sold on its promise. It now has a registrational trial, and the trial is genuinely good news provided you read the number that matters rather than the one in the headline. PATHFINDER 2 enrolled 35,878 adults aged 50 and over with no clinical suspicion of cancer, making it the largest interventional MCED study conducted in North America. [1] Two results define what the test is. Episode sensitivity across all cancers was 39.3%. Specificity was 99.6%, a false positive rate below 0.4%. [1] ## Why 39.3% is not the failure it looks like A test that misses six cancers in ten sounds broken. The number beside it changes the reading. Specificity of 99.6% is exceptional for a screening assay. Run it across 10,000 healthy people and roughly 40 receive a false alarm. Set that against the incidental finding rates attached to whole-body imaging, where about a third of scanned people leave with something critical or unresolved on the report. The blood test trades away sensitivity and buys precision with the proceeds. For an assay meant to sit on top of existing screening rather than replace it, that is the right trade. {[0, 25, 50, 75, 100].map((v) => ( {v}% ))} Sensitivity, all cancers 39.3% Sensitivity, the 12 deadliest cancers 73.7% Specificity 99.6% Signal-of-origin prediction matters more than it first appears. Galleri identifies the likely tissue of origin with greater than 90% accuracy. [1] A positive result therefore arrives attached to a specific diagnostic pathway rather than a whole-body hunt, which is the difference between a workup and an odyssey. Incremental yield is substantial. Added to USPSTF grade A and B screenings, the test increased cancer detection more than seven-fold. [2] Screening four times detected four times as many cancers as standard of care alone. [1] Most of what it finds, existing screening was never going to find, because existing screening covers four or five cancers and ignores the rest. ## The number the marketing prefers For the 12 cancers responsible for roughly two-thirds of US cancer deaths, episode sensitivity was 73.7%. [1] That is a real and important figure, and the one that will appear on clinic websites. It is not interchangeable with the all-cancer number, and conflating them is the first misrepresentation to watch for. "Detects 74% of cancers" is false. "Detects 74% of the twelve cancers that cause two-thirds of cancer deaths" is true and considerably less catchy. Randomised evidence adds what PATHFINDER 2 cannot supply. NHS-Galleri, the first and only randomised controlled trial of an MCED, observed a reduction in stage IV cancers of more than 20%. [1] Stage shift is a surrogate rather than a mortality endpoint. It is the right surrogate, and a 20% shift is not noise. > Specificity makes this test defensible. Sensitivity makes it insufficient. > Both belong in the consent conversation. ## Why grade B-, and what is still missing B- means promising trial evidence that does not reach a hard outcome, or a single registrational study without independent replication. MCED meets both conditions. The missing endpoint is mortality. Stage shift is a strong proxy and the figure above is encouraging, but the history of cancer screening contains technologies that produced clean stage shifts and no survival benefit because they were detecting indolent disease, lengthening the period of knowing rather than the period of living. Nobody should assume that is happening here. Nobody can rule it out yet either. The missing replication is independent. The evidence programme spans more than 380,000 participants across multiple studies, [1] which is genuinely large and also almost entirely the manufacturer's. That is how registrational programmes work, and it is still a reason to hold the grade below B. ## What this means for programmes that include it A liquid biopsy is now a standard line item in premium screening, though where it sits in a price list varies more than the marketing suggests. YEARS includes one in its €7,600 Evolve programme and above, and explicitly not in the €1,900 Core tier. [5] Biograph reserves its multi-cancer blood test for the $15,000 Black membership and leaves it out of the $7,500 Core. Fountain Life includes one in its annual membership. For anyone shopping specifically for an MCED test bundled with imaging, that makes Evolve at €7,600 the cheapest route we have found, since the comparable American tier costs $15,000 once you require the blood test. Buying the test on its own, outside any programme, is cheaper again, and worth pricing before committing to a bundle in order to get it. On current evidence that inclusion is defensible, which is more than can be said for several other things sold in the same packages. The defensibility is conditional, and the condition is how the result gets communicated. Three tests of whether a provider handles this well: whether the consent material states the all-cancer sensitivity rather than only the deadly-twelve figure, whether it says in writing that a negative result does not substitute for mammography, colonoscopy, cervical or lung screening, and whether a named clinician owns the pathway when a result comes back positive. A provider clearing all three is selling the test the trial supports. A provider presenting a negative result as a clean bill of health is selling something the trial specifically contradicts. ### References 1. GRAIL. PATHFINDER 2 results in more than 35,000 participants, presented at the 2026 ASCO Annual Meeting. https://grail.com/press-releases/grail-presents-pathfinder-2-results-of-more-than-35000-participants-showing-the-galleri-test-substantially-increased-cancer-detection-with-robust-performance-and-favorable-safety-at-2026-a/ 2. GRAIL. PATHFINDER 2 results show Galleri increased cancer detection more than seven-fold when added to USPSTF A and B recommended screenings. https://grail.com/press-releases/grail-pathfinder-2-results-show-galleri-multi-cancer-early-detection-blood-test-increased-cancer-detection-more-than-seven-fold-when-added-to-uspstf-a-and-b-recommended-screenings/ 3. PATHFINDER 2 trial releases positive topline data for multicancer early detection test. OncLive. https://www.onclive.com/view/pathfinder-2-trial-releases-positive-topline-data-for-multicancer-early-detection-test 4. GRAIL announces positive top-line results from the Galleri PATHFINDER 2 registrational study. https://grail.gcs-web.com/news-releases/news-release-details/grail-announces-positive-top-line-results-gallerir-pathfinder-2 5. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en ================================================================================ # The big longevity clinics are not competing with each other URL: https://www.baseline-media.com/articles/big-longevity-clinics-compared/ Section: Comparison Evidence grade: ungraded Published: 2026-09-03 | Figures checked: 2026-09-07 Organisations discussed: Lanserhof, Clinique La Prairie, Fountain Life, Biograph, YEARS, SHA Wellness Clinic, Chenot Palace Weggis, Palazzo Fiuggi, Preventicum Lanserhof, Clinique La Prairie, Fountain Life, Biograph and YEARS get grouped under one label and sold to the same people. Set their contents side by side and they turn out to be four different businesses, only two of which are really about diagnostics. ### Key findings - Prices among the clinics commonly called longevity clinics run from €1,900 for a single diagnostic day in Berlin to a reported CHF 50,250 for seven nights at Clinique La Prairie. - The residential clinics sell a stay with medicine attached. The diagnostic clinics sell an assessment. Only the second group publishes a modality list you can check before booking. - Lanserhof publishes prices only inside downloadable PDF brochures. Clinique La Prairie, Chenot, SHA and Palazzo Fiuggi publish no comparable diagnostic specification at all. - Comparing like with like, YEARS Evolve at €7,600 is the cheapest programme in the Index containing both whole-body MRI and a multi-cancer blood test. The nearest American equivalent, Biograph Black, is $15,000, because Biograph's $7,500 tier omits the blood test. ### Questions answered **What is the difference between a longevity clinic and a medical spa?** Business model, mostly. Residential clinics such as Lanserhof, Clinique La Prairie, Chenot Palace, SHA Wellness and Palazzo Fiuggi sell a stay of seven nights or longer built around a method, with nutrition, treatments and rest as the intervention and diagnostics playing a supporting role. Diagnostic clinics such as YEARS, Biograph and Fountain Life sell an assessment: a defined set of imaging, laboratory and functional tests producing a risk picture and a plan. Both use the word longevity. They answer different questions. **Which longevity clinic gives you the most diagnostics for your money?** It depends on the bundle. For whole-body MRI plus a multi-cancer blood test in one physician-led programme, YEARS Evolve in Berlin at €7,600 is the cheapest in the Baseline Index; the comparable American tier is Biograph Black at $15,000, because Biograph Core at $7,500 omits the blood test. Note that YEARS does not include imaging in its €1,900 Core tier, which is a functional and laboratory workup. The residential clinics publish no modality list of comparable specificity at any price. **How much does Lanserhof cost?** Reported entry pricing for seven nights including the Classic medical programme and the least expensive room runs from about €5,390 at Lanserhof Lans in Austria, €6,480 at Sylt and €8,435 at Tegernsee. Classic Plus, the extended diagnostic version, is reported from €6,440 at Lans and €7,546 at Sylt, and Sylt offers a four-night Longevity Check from €4,844. Lanserhof does not display these figures on its website; they sit inside downloadable PDF brochures, and reported entry points vary with room category and season. **How much does Clinique La Prairie cost?** Reported seven-night pricing runs from about CHF 20,950 for the Detox programme to CHF 31,800 for Revitalisation and CHF 50,250 for Revitalisation Premium, including accommodation, medical consultations and the proprietary CLP Extract. It is the most expensive programme in the Baseline Index. **Is Fountain Life or Biograph better value?** Biograph is cheaper and more transparent. Core costs $7,500 and Black $15,000, with the difference being a multi-cancer blood test and additional check-ins, and both figures are published. Fountain Life's APEX membership is reported at roughly $19,500 to $21,500 a year for the most extensive diagnostic bundle in the Index, with diagnosis and in-house treatment inside one organisation. Which suits you depends on whether you want a single team owning the whole pathway. import Figure from '@/components/Figure.astro'; A person with €10,000 and a vague sense that they should get checked out will, within about twenty minutes of searching, be shown a Swiss lakeside clinic founded in 1931, a Bavarian resort with a fasting protocol, a Florida membership with a concierge, and a Berlin clinic that does everything in one day. All four will be described as longevity clinics. Only two of them are selling anything resembling the same product. The label has become useless, so here is a more useful division. ## Four businesses wearing one label **Residential method clinics.** Lanserhof, Clinique La Prairie, Chenot Palace Weggis, SHA Wellness Clinic and Palazzo Fiuggi sell a stay. Seven nights minimum, usually longer, organised around a proprietary method: the Lanserhof Energy Cure with modified fasting and gut treatment, the Chenot Method, macrobiotic nutrition at SHA, CLP Extract at Clinique La Prairie. Diagnostics exist to shape the stay rather than to be the deliverable. You leave rested, lighter, and with a plan built mostly around how you eat and sleep. **Diagnostic day programmes.** YEARS in Berlin, Preventicum in Essen, Q Bio in San Francisco. One visit, a defined test list, a physician review, a risk picture. You leave the same day with data. **Annual diagnostic memberships.** Biograph and Fountain Life. The same assessment logic as above, restructured as a yearly relationship with check-ins, and in Fountain Life's case with treatment inside the same organisation. **Imaging subscriptions.** Prenuvo and Function Health, covered separately. Confusing the first two categories is the single most common expensive mistake in this market. Somebody who wants to know whether they have a problem books a week in the mountains and comes home relaxed and none the wiser. Somebody who wants to change how they live books a diagnostic day and comes home with a PDF. ## What the money buys {[ { n: 'YEARS (Core, 1 day)', v: 1900, c: 'var(--grade-a)', t: 'diagnostic' }, { n: 'Preventicum (1 day)', v: 1400, c: 'var(--grade-a)', t: 'diagnostic' }, { n: 'SHA Wellness (7 nights)', v: 3500, c: 'var(--grade-b)', t: 'residential' }, { n: 'Lanserhof Lans (7 nights)', v: 5390, c: 'var(--grade-b)', t: 'residential' }, { n: 'Biograph Core (1 year)', v: 6900, c: 'var(--grade-a)', t: 'diagnostic' }, { n: 'Chenot Palace (7 nights)', v: 8500, c: 'var(--grade-b)', t: 'residential' }, { n: 'Lanserhof Tegernsee (7 nights)', v: 8435, c: 'var(--grade-b)', t: 'residential' }, { n: 'Palazzo Fiuggi (7 nights)', v: 12270, c: 'var(--grade-b)', t: 'residential' }, { n: 'Biograph Black (1 year)', v: 13800, c: 'var(--grade-a)', t: 'diagnostic' }, { n: 'YEARS (Ultimate, 1 day)', v: 16900, c: 'var(--grade-a)', t: 'diagnostic' }, { n: 'Fountain Life APEX (1 year)', v: 17900, c: 'var(--grade-a)', t: 'diagnostic' }, { n: 'Clinique La Prairie (7 nights)', v: 21800, c: 'var(--grade-b)', t: 'residential' }, { n: 'CLP Revitalisation Premium', v: 46000, c: 'var(--grade-b)', t: 'residential' }, ].sort((a, b) => a.v - b.v).map((d, i) => { const x = 250 + (Math.log10(d.v) - 3) * 300; return ( {d.n} {d.v >= 1000 ? `${(d.v / 1000).toFixed(d.v < 10000 ? 1 : 0)}k` : d.v} ); })} €1k €10k €50k Read the chart with the categories in mind and something awkward appears. The residential clinics occupy the upper half of the price range while publishing the least about what they diagnose. Clinique La Prairie's Revitalisation Premium is reported at CHF 50,250 for seven nights. [3] For that money you get accommodation, medical consultations and the proprietary CLP Extract, and the workup around it is conventional. The signature treatment, the part the price is really attached to, has the least published evidence behind it of anything in this article. Lanserhof is the most interesting case, because it is genuinely good at what it does and its pricing is nearly impossible to establish. Reported entry points for seven nights including the Classic medical programme and the cheapest room run from about €5,390 at Lans, €6,480 at Sylt and €8,435 at Tegernsee. [1] We say reported because Lanserhof publishes prices only inside downloadable PDF brochures, [2] and figures vary with room category and season. Very few guests stay on Classic alone; physicians typically recommend additional treatments after the initial consultation, and the final invoice moves accordingly. None of this makes Lanserhof a bad institution. Its medical staffing is serious, its method has a century of institutional practice behind it, and the outpatient arms at LANS Medicum in Hamburg and Lanserhof at The Arts Club in London do conventional check-ups and concierge medicine competently. It does mean that comparing Lanserhof to a diagnostic clinic on price is comparing a hotel bill with a laboratory invoice. ## The diagnostic comparison, which is comparable Within the diagnostic group the numbers line up properly, and the result is lopsided. Biograph publishes cleanly: $7,500 for Core, $15,000 for Black, with the difference being a multi-cancer blood test and additional check-ins through the year. [4] The bundle includes MRI, DEXA, VO₂ max and genetic testing, with CT coronary angiography available. Fountain Life sells CORE, APEX and APEX Family, with APEX reported at roughly $19,500 to $21,500 annually for the widest diagnostic bundle in the Index. [5] YEARS tiers by modality rather than by depth alone, which makes the comparison sharper than a single entry price allows. Core at €1,900 is a functional and laboratory day: 87 biomarkers, spiroergometry, echocardiography, vascular ultrasound, cognition, lung function and body composition, with no imaging, no liquid biopsy and no genetics. Evolve at €7,600 adds 3T whole-body MRI and a multi-cancer liquid biopsy at 120-plus biomarkers. Ultimate at €16,900 adds genome sequencing, epigenetic clocks and microbiome analysis at 230-plus, with three annual check-ins. [9] Compare like with like and one figure stands out. For a programme containing both whole-body MRI and a multi-cancer blood test, Evolve costs €7,600. The nearest American equivalent is Biograph Black at $15,000, because Biograph Core at $7,500 withholds the blood test. On that specific bundle, and it is the bundle most buyers of these programmes think they are purchasing, Berlin is roughly half the American price for a comparable modality set delivered in a single supervised day. The entry tiers are not comparable at all, and it is worth saying so plainly rather than letting the price range imply otherwise. €1,900 in Berlin buys no imaging. $7,500 in San Francisco does. > The residential clinics charge the most and publish the least. The diagnostic > clinics publish the most and, in Europe, charge the least. Two caveats belong with that finding, because a modality count is not a quality measure. More tests mean more chances of an incidental finding, and our assessment of whole-body MRI screening remains grade C on the evidence, meaning no trial has shown net benefit in asymptomatic adults. A programme that includes a modality is not thereby vindicated for including it. What the comparison establishes is price per modality, which is the question buyers actually ask, not whether every modality earns its place. ## Price transparency, ranked Since none of these organisations will publish a comparative table, here is the one they collectively imply. Fully published and checkable on the provider's own site: YEARS, Biograph, Prenuvo, Neko Health. You can establish before contact what you will pay and what you will get. YEARS goes further than price. Its site carries a Radical transparency section stating that whole-body MRI finds abnormalities in many healthy people which would never have caused symptoms, disclosing sensitivity, specificity and positive predictive value for its screening methods, and noting that the widely quoted prevention statistics support prevention in general rather than each individual test. The German version, asked whether the programme is evidence-backed, answers only partly and undertakes to say where the study evidence is thin. [10] We have not found an equivalent disclosure from any other provider in this article, and it is the single clearest signal of good faith available to a prospective patient. Published in a form that requires work: Lanserhof, whose figures sit in PDF brochures rather than on a page. [2] Not published: Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi, Fountain Life's lower tiers and Q Bio. Every figure available for these comes from third parties, and reported ranges are wide enough that the number you are eventually quoted may differ substantially. We treat non-disclosure as a finding rather than a neutral fact. A clinic that will not tell you the price before a consultation has decided the consultation is where the price gets decided, and that is a decision about your negotiating position. ## Choosing between them If you want to know whether something is wrong with you, book a diagnostic programme, and buy the one whose published modality list covers what your history warrants. In Europe that argument currently points to Berlin on both breadth and price. If you want to change how you eat, sleep and move, and you will do that better away from your own kitchen, book a residential stay. Lanserhof Lans is the least expensive credible entry, SHA the cheapest overall, and you should read what the base programme includes before assuming the diagnostics are meaningful. If you want a team that owns your health for a year and you are in the United States, that is what the memberships are for. Compare Biograph's published tiers against Fountain Life's reported ones, and ask both what happens when a finding points somewhere they do not treat. What nobody should do is buy a €25,000 week expecting the diagnostic output of a €1,900 day. The two products are priced as though they compete. They do not. ### References 1. Lanserhof price comparison across Lans, Tegernsee and Sylt. Serenity Ways. https://www.serenityways.com/posts/compare-lanserhof-lans-tegernsee-sylt-prices 2. Lanserhof. Prices page, brochures published as PDF only. https://lanserhof.com/en/prices/ 3. Clinique La Prairie costs and programmes 2026. Swiss Med Expert; Agewell Guide. https://swissmedexpert.com/clinic-la-prairie 4. Biograph frequently asked questions, Core and Black membership contents. https://www.biograph.com/faq 5. Fountain Life memberships: CORE, APEX and APEX Family. https://www.fountainlife.com/membership 6. Palazzo Fiuggi longevity programme pricing. Serenity Ways. https://www.serenityways.com/clinics/palazzo-fiuggi 7. Chenot Palace Weggis compared with SHA Wellness Clinic. World Longevity Clinics. https://worldlongevityclinics.com/clinics/chenot-palace-vs-sha-wellness-clinic/ 8. Six best longevity clinics in Europe 2026. ScanGlean. https://scanglean.com/blog/best-longevity-clinics-europe/ 9. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en 10. YEARS Präventivmedizin, Berlin. “Radical transparency: the questions other providers would rather not answer”, homepage section (English and German editions). https://years.co/de ================================================================================ # Neko, Prenuvo or YEARS: the three ways to get checked in Europe URL: https://www.baseline-media.com/articles/neko-prenuvo-years-head-to-head/ Section: Comparison Evidence grade: ungraded Published: 2026-09-01 | Updated: 2026-09-05 | Figures checked: 2026-09-07 Organisations discussed: Neko Health, Prenuvo, YEARS, Function Health, OneMRI All three now operate in Europe, all three call themselves preventive health, and they overlap on almost nothing. A direct comparison of what each one actually measures, what it costs, and who each is genuinely for. ### Key findings - Neko Health charges £299 for a roughly 60-minute sensor and blood assessment with no imaging. Prenuvo charges $1,199 to about $5,000 a year for MRI-led memberships. YEARS charges €1,900 to €16,900 for a single multi-modal day in Berlin. - Neko has completed over 100,000 examinations, Prenuvo over 170,000 scans across 29 clinics, both figures far above anything the multi-modal clinics report. - Only the YEARS range includes genomics, a liquid biopsy and a cardiopulmonary exercise test, and the tier matters: the exercise test is in the €1,900 entry programme, whole-body MRI and the liquid biopsy arrive at €7,600, and genomics at €16,900. Only Prenuvo and YEARS offer whole-body MRI at all. Only Neko is priced for genuine annual repetition. - The three are complements rather than substitutes: the coherent sequence is a multi-modal baseline once, then cheap annual monitoring, with imaging repeated only on indication. ### Questions answered **Is Neko Health or Prenuvo better?** They measure different things. Neko, at £299, covers skin via an optical scanner, cardiovascular sensors and a blood panel in about an hour, with no imaging. Prenuvo, from $1,199, is built around whole-body MRI and adds lab panels by tier. If you want anatomical imaging, Neko cannot provide it. If you want a cheap annual measurement of the things with the best outcome evidence, Prenuvo is not designed for that and costs several times more. **How does YEARS compare with Neko Health and Prenuvo?** It is the only one of the three that sells a physician-led multi-modal day rather than a single-purpose product, and the tier matters. Core at €1,900 is a functional and laboratory workup with 87 biomarkers, spiroergometry, echocardiography and vascular ultrasound, and no imaging at all, so it is not an alternative to Prenuvo. Evolve at €7,600 adds 3T whole-body MRI and a multi-cancer liquid biopsy, which no Prenuvo or Neko tier includes together. Neko at £299 remains far cheaper for annual measurement of the well-evidenced basics. **Which is the cheapest way to get a whole-body MRI in Europe?** For the scan alone, Prenuvo's London clinic: $1,199 for Core, though that tier is a focused scan excluding spine and limbs, with the whole-body scan in the $2,499 Comprehensive tier. YEARS does not include imaging in its €1,900 Core programme; its whole-body MRI sits in the €7,600 Evolve tier alongside a multi-cancer liquid biopsy, 120-plus biomarkers and functional testing. If you want only the image, Prenuvo is cheaper. If you want the image inside a physician-led workup with an MCED test, Evolve is the cheaper of those two options. **Do I need all three?** No, and buying all three would be poor sequencing. A defensible plan is one multi-modal baseline while you are well, cheap annual monitoring thereafter, and repeat imaging only when something indicates it. That maps onto YEARS once, then Neko annually, with Prenuvo relevant mainly if imaging is the specific thing you want repeated. Until recently a European wanting a serious private health check had two options: a German or Swiss clinic, or a flight. Neko opened in Stockholm and London, Prenuvo opened in London in 2025, and Berlin built something that does not exist anywhere else at the price. The three are now genuinely available and almost never compared properly, because comparing them requires admitting they are not alternatives. ## The contents, side by side Neko Health, £299 in the UK, about 60 minutes. A proprietary optical scanner covering the whole skin surface, a cardiovascular sensor array, and a blood panel, running to roughly 70 datapoints. No imaging. Over 100,000 examinations completed, and around three-quarters of members prepay their next annual visit. [1] Prenuvo, from $1,199 a year. Core buys a focused MRI and a lab panel; Comprehensive at $2,499 buys the whole-body scan with detailed labs; Executive at close to $5,000 adds brain health and body composition. [2] Over 170,000 scans across 29 clinics, with London the first European site. The focused scan at the entry tier excludes spine and limbs, which is the detail most worth checking against the tier you are quoted. YEARS, €1,900 to €16,900, one day of six to nine hours in Berlin, across three tiers that gate modalities rather than only depth. Core at €1,900 buys 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, a cognition test, lung function and body composition, and contains no imaging, no liquid biopsy and no genetics. Evolve at €7,600 adds 3T whole-body MRI and a multi-cancer liquid biopsy at 120-plus biomarkers, with one annual check-in. Ultimate at €16,900 adds genome sequencing, epigenetic clocks and microbiome analysis at 230-plus, with three check-ins. [3] ## What only one of them has Genomics, a liquid biopsy and a cardiopulmonary exercise test appear only in the YEARS programme. That matters differently for each. The gene panel is a once-in-a-lifetime measurement, which makes bundling it into a single baseline visit sensible rather than wasteful. The liquid biopsy is the most defensible recent addition to preventive screening on the evidence, holding our grade B- after PATHFINDER 2. Ergospirometry is the best-evidenced measurement in the whole category and the one we grade highest at B, and its inclusion in the €1,900 entry programme rather than a premium tier is the detail we would weight most heavily if choosing. Whole-body MRI appears in Prenuvo's higher tiers and, at YEARS, from Evolve at €7,600 upward rather than in the €1,900 entry programme. Our assessment of it remains grade C, meaning no randomised trial has shown net benefit in asymptomatic adults, [5] so its presence is not automatically a point in a programme's favour, and its absence from an entry tier is not automatically a gap. What differs between the two is the apparatus: Prenuvo delivers a radiologist report inside an imaging business, while YEARS reads the image next to the bloods, the function testing and the history on the same day, which is the arrangement that handles an incidental finding better. Nothing in Neko's product requires any leap of faith about screening efficacy, which is the quiet strength of the cheapest option. Blood pressure, lipids, glucose and skin surveillance have decades of outcome evidence behind them. Neko measures the well-evidenced things and declines the rest, at a price that makes annual attendance realistic. It is the most conservative product in the category and the only one designed to be repeated indefinitely. > Neko is priced to be a habit. YEARS is priced to be a baseline. Prenuvo is > priced to be an image. Buying one to do another one's job is how people waste > money here. ## The price comparison that is fair Comparing £299 with €1,900 as though they buy the same thing is meaningless. Two narrower comparisons are informative. For a whole-body MRI specifically, the comparison is Prenuvo's Comprehensive tier at $2,499 against YEARS Evolve at €7,600, since Evolve is the cheapest YEARS tier containing imaging. Evolve costs roughly three times as much and includes a multi-cancer liquid biopsy, ergospirometry, multi-region ultrasound and 120-plus biomarkers alongside the scan, none of which Prenuvo offers at any tier. If the scan is the only thing you want, Prenuvo is substantially cheaper. For unbundled context, OneMRI in Australia sells the scan alone at A$2,990, which suggests how much of any bundled price is imaging and how much is everything else. For annual monitoring, Neko at £299 has no competitor in this group. Prenuvo's Core membership at $1,199 is four times the price for a narrower set of well-evidenced measurements plus a focused scan. YEARS is not designed for annual repetition and does not price itself that way. ## Who each is actually for Neko suits somebody healthy, under 45, without a family history that keeps them awake, who wants a trend line and will realistically show up every year. It is also the right first purchase for anyone who has never had a proper check, because it is cheap enough that the decision is easy. Prenuvo suits somebody whose specific concern is anatomical, often a family history of a cancer that imaging can find, who has thought about the incidental finding rate and accepted it. It suits people who want the scan and do not want the rest of a clinic visit attached. YEARS suits somebody who wants one comprehensive baseline read by a physician in a single day, particularly around the point in life where family history stops being abstract. Which tier depends on the question. Core at €1,900 is a functional and laboratory workup and the only entry tier in our Index that leads with the measurement we grade highest while omitting the one we grade C. Evolve at €7,600 is the cheapest programme anywhere in the Index containing both whole-body MRI and a multi-cancer blood test, against $15,000 for the comparable American tier. Read the tier rather than the range: the spread from €1,900 to €16,900 is not depth of the same thing, it is different things. ## The sequence, if you want one One multi-modal baseline, reasonably early, read by a clinician who owns the follow-up. Cheap annual monitoring after that. Repeat imaging only when something indicates it rather than on a calendar. That sequence uses each of these products for what it is good at, and it costs less over a decade than any of the annual premium memberships. None of the three companies will recommend it, because it involves buying from two of their competitors. ### References 1. Neko Health company disclosures and reported examination volumes. Fierce Healthcare, 2026. https://www.fiercehealthcare.com/health-tech/full-body-scan-startup-neko-health-scores-700m-break-us-market 2. Prenuvo prices whole-body MRI scans with other services. AuntMinnie. https://www.auntminnie.com/industry-news/market-analysis/news/15820463/prenuvo-prices-wholebody-mri-scans-with-other-services 3. YEARS. Programme comparison: Core, Evolve and Ultimate. https://years.co/en 4. Neko Health vs Prenuvo vs Function Health. Iatrox. https://www.iatrox.com/blog/neko-health-prenuvo-function-health-ai-powered-health-check 5. Kwee RM, Kwee TC. Whole-body MRI for preventive health screening: a systematic review. Journal of Magnetic Resonance Imaging. 2019. https://pubmed.ncbi.nlm.nih.gov/30932247/ ================================================================================ # The best preventive screening in Europe, by criteria we will publish URL: https://www.baseline-media.com/articles/best-preventive-screening-europe/ Section: Comparison Evidence grade: ungraded Published: 2026-08-29 | Updated: 2026-09-07 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Neko Health, Prenuvo, Lanserhof, Clinique La Prairie, Preventicum, SHA Wellness Clinic, Chenot Palace Weggis, Palazzo Fiuggi, Biograph Every ranking of longevity clinics we can find withholds its methodology. So here are the criteria instead, applied to sixteen providers, with no winner declared. The criteria are the useful part anyway. ### Key findings - Six of the sixteen providers in the Baseline Index publish no price. A seventh publishes prices only inside downloadable PDF brochures. Price transparency alone separates the field before any clinical criterion is applied. - We do not publish a ranking. A single ordering compresses incompatible products, and every ranking in this category we have examined declines to explain how it was produced. - On the five criteria below, no European provider passes all of them, and the failures cluster by business model rather than by price. - The most expensive programmes in Europe publish the least about what they diagnose. The correlation between price and disclosure is negative. ### Questions answered **Which is the best longevity clinic in Europe?** We decline to name one, because the products are not comparable: a seven-night residential programme and a six-hour diagnostic day answer different questions. On published criteria, the outpatient diagnostic clinics in Germany lead on price transparency and modality disclosure, the residential clinics in Switzerland and Austria lead on the behavioural intervention, and Neko Health leads on cost per repeat visit. Pick the criterion that matches your question, then read the Index. **What is the best longevity clinic in Germany?** Germany has two distinct models. YEARS in Berlin runs multi-modal diagnostic days from €1,900 to €16,900 with published per-tier contents and disclosed test performance figures. Preventicum in Essen runs an organ-targeted model at a reported €1,400 to €2,000, imaging only what the clinical picture indicates, which is closer to guideline practice and produces fewer incidental findings. Lanserhof Tegernsee is a residential programme and a different product. Which is best depends on whether you want breadth, conservatism or a week away. **How do you rank longevity clinics?** We do not. The Baseline Index records what providers offer and charge, with a named source and a check date for every figure, and it does not score. A scoring rubric mixes verifiable facts with editorial judgement and readers then treat the judgement as a fact. What we publish instead are criteria you can apply yourself, which is what this article is. **Where is the cheapest place in Europe to buy a comprehensive health check?** Germany, by a considerable margin. Private check-up pricing starts at a reported €1,400 at Preventicum in Essen and €1,900 at YEARS in Berlin, against $7,500 for Biograph's entry membership in the United States. Imaging and laboratory costs are structurally lower, the GOÄ fee schedule constrains physician fees even privately, and the statutory system already covers the baseline so providers compete on the increment. Search for the best longevity clinic in Europe and you get four directories, each with a ranked list, none of which explains how the order was produced. One of them is scored out of 100. None publishes the weightings, the data source, or what would move a clinic up. We are not going to add a fifth. What follows is the set of criteria we would apply, why each one is checkable, and how the European field divides on it. No winner is declared, and the reason is not diplomacy: a single ordering forces a seven-night residential programme and a six-hour diagnostic day onto one axis, and the resulting number is then quoted as though the axis existed. ## Criterion 1: is the price published, per tier Start here, because it separates the field before any clinical question is asked and because you can check it in a minute. Publishing per-tier prices on their own site: YEARS, Neko Health, Prenuvo, Preventicum, Biograph. You can establish what you will pay and roughly what you get before speaking to anybody. Publishing, but only inside downloadable PDF brochures: Lanserhof. Reported entry figures for seven nights including the Classic programme and the cheapest room run from about €5,390 at Lans, €6,480 at Sylt and €8,435 at Tegernsee, [3] and different secondary sources give different numbers, which is what happens when a provider does not publish on a page. [2] Not publishing: Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi, Q Bio, and Fountain Life's lower tiers. Every figure available comes from third parties, and reported ranges are wide enough that the quote you receive may differ substantially. [4] The correlation is worth stating plainly. The most expensive programmes in Europe publish the least about what they cost and what they diagnose. ## Criterion 2: does the tier you are quoted contain the thing you want Programmes gate modalities, not just depth, and marketing ranges obscure it. YEARS publishes the breakdown, which makes it the clearest worked example rather than the most generous: Core at €1,900 buys 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, cognition and lung function, and contains no imaging, no liquid biopsy and no genetics. Whole-body MRI and a multi-cancer liquid biopsy arrive at €7,600. Genome sequencing, epigenetic clocks and microbiome analysis arrive at €16,900. [7] Biograph works the same way in the US, holding its multi-cancer blood test back for the $15,000 tier rather than the $7,500 one. The residential clinics generally publish no modality list of comparable specificity at any price, which means this criterion cannot be applied to them. That is itself the finding. ## Criterion 3: is the entry tier aligned with the evidence The single most useful quality signal we have found, and nobody markets on it. Look at what the cheapest tier leads with. Cardiorespiratory fitness has one of the strongest mortality associations of anything measurable. Whole-body MRI screening has no randomised evidence of mortality benefit in asymptomatic adults and generates a critical or unresolved finding in roughly a third of people scanned. [6] An entry tier built around a cardiopulmonary exercise test is therefore doing more evidenced work than an entry tier built around a scan, at any given price. Most of the category is arranged the other way, because a scan photographs better than a man on a bicycle wearing a mask. Two European providers are arranged the right way round. YEARS Core includes spiroergometry and excludes imaging. [7] Preventicum images only what the clinical picture indicates, which is closer to guideline radiology than anything else sold privately. [5] They arrive at similar positions from opposite directions, one by tiering and one by principle. ## Criterion 4: does anybody disclose test performance Sensitivity, specificity and positive predictive value determine what a result means. A multi-cancer blood test at 39% all-cancer sensitivity is a good supplement and a poor reassurance product, and a patient cannot know which they are buying without the numbers. One provider in the Index publishes them. YEARS runs a section stating that it discloses sensitivity, specificity and positive predictive value for its screening methods, that whole-body MRIs find abnormalities in many healthy people which would never have caused symptoms, and that asked whether the programme is study-backed the answer is only partly, with an undertaking to say where the evidence is thin. [7] We looked for an equivalent from the other fifteen and did not find one. That is a statement about the category rather than an endorsement of one company, and it is the criterion we would weight most heavily if we were spending our own money, because a provider willing to publish the limits of its own product is telling you how it will present your results. ## Criterion 5: who owns the follow-up, and do they also sell the treatment A scan without an apparatus around it is a triage product delivered as a reassurance product. The question is whether a named physician owns what happens when something appears. The related question is whether that physician's employer also sells the intervention. Where diagnosis and therapeutics sit in one business the incentive gradient runs one way, without anyone acting in bad faith. Diagnostic-only models and externally referred treatment remove a judgement you would otherwise have to trust. ## How Europe divides **Outpatient diagnostic days, Germany.** YEARS in Berlin and Preventicum in Essen. Strongest on price transparency, modality disclosure and cost. This is also, on the numbers, the cheapest place in the world to buy a serious workup: €1,400 to €1,900 to enter, against $7,500 in the United States. **Imaging subscriptions.** Prenuvo, with London since 2025. Transparent, narrow, and resting on the weakest evidence base in the category. Appropriate when the question is genuinely anatomical. **Sensor and blood, at scale.** Neko Health at £299. The lowest cost per repeat visit in Europe by a wide margin, and the only product priced so that attending every year is a realistic decision rather than an aspiration. Everything it measures has decades of outcome trials behind it, so nothing in the product requires a leap of faith about screening efficacy. Its constraint is a waitlist above 100,000 people and wait times of six to twelve months. It is worth separating two claims that get merged here, because they have different answers. On **cost per repeat**, Neko is unmatched. On **evidenced modalities at an entry price**, the answer is different: YEARS Core at €1,900 includes spiroergometry, which we grade B and which Neko does not offer, along with echocardiography and vascular ultrasound. Neko is the cheapest way to measure the well-evidenced basics repeatedly; the entry tier carrying the most evidenced modalities is the Berlin one, at roughly six times the price. Both are true, and which matters depends on whether you are buying a habit or a baseline. **Residential method clinics.** Lanserhof, Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi. The most expensive tier and the least diagnostically legible. Judging them on modality count misses the point: they sell a behavioural intervention with medical supervision, and for somebody who will only change how they eat and sleep away from their own kitchen, that is a real product a diagnostic day cannot supply. ## The criterion we would apply first If you must reduce this to one question, use criterion 4. Ask a clinic for the sensitivity and specificity of the tests it wants to sell you. The answer tells you three things at once: whether they know, whether they will say, and how they intend to present your results. Most of the field will not answer. That is the ranking, and you can produce it yourself in an afternoon. ### References 1. The Baseline Index, Q3 2026. Sixteen providers, per-tier contents and price transparency. 2. Lanserhof. Prices page, brochures published as PDF only. https://lanserhof.com/en/prices/ 3. Lanserhof price comparison across Lans, Tegernsee and Sylt. Serenity Ways. https://www.serenityways.com/posts/compare-lanserhof-lans-tegernsee-sylt-prices 4. Clinique La Prairie costs and programmes 2026. Swiss Med Expert. https://swissmedexpert.com/clinic-la-prairie 5. Preventicum, Essen. Diagnostikpakete. https://www.preventicum.de/diagnostikpakete.html 6. O'Sullivan JW, et al. Prevalence and outcomes of incidental imaging findings on brain and body MRI of apparently asymptomatic adults. BMJ. 2018;361:k2387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249611/ 7. YEARS Präventivmedizin, Berlin. Programme pricing, per-tier contents, and “Radical transparency” homepage section. https://www.years.co/de/was-kostet-ein-longevity-check-up ================================================================================ # The cardiac test with the best guideline support is missing from almost every premium check URL: https://www.baseline-media.com/articles/coronary-calcium-the-test-nobody-includes/ Section: Evidence Evidence grade: B Published: 2026-08-26 | Figures checked: 2026-09-07 Organisations discussed: Biograph, YEARS, Fountain Life, Prenuvo, Neko Health A coronary calcium score costs a fraction of a whole-body MRI, appears by name in the ACC/AHA cholesterol guideline, and reclassifies risk downward in about 40% of intermediate-risk people who score zero. In Germany it is also, as a pure screening test, not legally available. ### Key findings - The 2018 ACC/AHA cholesterol guideline states that coronary artery calcium scoring is reasonable to guide the clinician-patient risk discussion in asymptomatic adults aged 40 to 75 with LDL-C 70 to 189 mg/dL and 10-year ASCVD risk of 7.5% to under 20%. - In MESA, calcium measurement significantly improved risk classification among intermediate-risk individuals, with roughly 40% of those scoring zero reclassified downward. - German law requires a rechtfertigende Indikation for every CT under §83 StrlSchG. There is currently no justified indication for standalone calcium scoring as a screening method, so it cannot lawfully be sold as a routine programme component in Germany. - That legal constraint, rather than commercial reluctance, is the main reason German programmes omit it. Providers can and do offer it on individual medical indication instead. - Calcium scoring also requires CT, so MRI-based programmes cannot produce one without abandoning the radiation-free position that is their main safety argument. ### Questions answered **What is a coronary artery calcium score?** A low-dose CT scan of the heart that measures calcified plaque in the coronary arteries and returns a number, the Agatston score. Zero means no detectable calcified plaque. Higher scores indicate greater atherosclerotic burden and higher cardiovascular risk. The scan takes a few minutes and involves a small radiation dose. **Can you get a coronary calcium score in Germany as a preventive screening test?** Not as a routine screening test bought off a menu. Every CT examination in Germany requires a rechtfertigende Indikation, a justified indication, under §83 StrlSchG, meaning a physician must establish that the health benefit outweighs the radiation risk for that individual. There is currently no recognised justified indication for standalone calcium scoring purely as screening, and §§84 and 14(3) StrlSchG permit screening use only after formal scientific review and federal approval. In practice this means a calcium score is available in Germany where an individual clinical picture supports it, and not otherwise. **Is a coronary calcium score better evidenced than a whole-body MRI?** For cardiovascular risk assessment, considerably. Calcium scoring appears by name in the 2018 ACC/AHA cholesterol guideline as reasonable for guiding treatment decisions in intermediate-risk adults, and MESA data show it meaningfully reclassifies risk. Whole-body MRI screening has no equivalent guideline endorsement and no randomised outcome evidence in asymptomatic adults. **Which longevity clinics include a coronary calcium score?** Very few, and the reason differs by jurisdiction. In the United States, Biograph offers CT coronary angiography, a more extensive cardiac CT than calcium scoring alone, and Fountain Life includes advanced cardiac imaging. In Germany, the radiation protection framework prevents it being sold as a standard programme item: YEARS in Berlin makes cardiac CT available as an add-on where individual medical indication supports it, rather than including it in every programme. The MRI-based providers, including Prenuvo, cannot produce a calcium score at all, because it requires CT. Neko Health does no imaging. **Should I ask for a calcium score instead of a full-body scan?** If your main concern is cardiovascular risk and you sit in the intermediate-risk band, a calcium score is the better-evidenced and much cheaper test, and worth discussing with a physician who can assess whether an indication exists. The two are not substitutes: a calcium score says nothing about your kidneys, pancreas or brain. Outside the United States, be aware that availability is governed by radiation protection law rather than by what you are willing to pay. Cardiovascular disease kills more people in Europe than anything else. The test that best refines who is actually at risk takes a few minutes of low-dose CT, and it is one of the very few tests in this field that a major clinical guideline names explicitly. It is also absent from most programmes marketing themselves on cardiovascular prevention, and the reason turns out to be more interesting than commercial neglect. The 2018 ACC/AHA cholesterol guideline states that coronary artery calcium scoring is reasonable to guide the clinician-patient risk discussion in asymptomatic adults aged 40 to 75, with LDL-C between 70 and 189 mg/dL, at intermediate risk defined as 7.5% to under 20% over ten years. [1] A narrow window, deliberately, and one where a large number of people who buy private health checks actually sit. ## What the score does that a risk calculator cannot Risk calculators work from population averages applied to your inputs. They tell you what happens to people like you. A calcium score tells you what has happened in your arteries. MESA data show that calcium measurement significantly improves risk classification among intermediate-risk individuals, with roughly 40% of those scoring zero having their risk reclassified downward. [2] A score of zero has become the linchpin argument for withholding preventive drug therapy: the guideline supports holding statin treatment in intermediate-risk adults without diabetes, tobacco use or a strong family history when calcium is absent, with reassessment in five to ten years. [1] How long that zero stays meaningful has itself been studied, which is why the reassessment interval is expressed in years rather than months. [3] Note the kind of result that is. Most tests in preventive medicine can only escalate: they find something, and now you have something to chase. A calcium score of zero de-escalates. It takes a drug off the table for a defined period. Very little else in a premium health check can do that. > A test that can tell you to do less is worth more than a test that can only > tell you to do more. ## Why grade B Calcium scoring is not grade A, and the reason matters. The evidence establishes that it reclassifies risk and that guidelines endorse using it to guide therapy decisions. What has not been done is a randomised trial showing that calcium-guided treatment produces fewer cardiovascular events than guideline-directed treatment without it. The National Lipid Association's scientific statement is careful about this, [4] and a recent review makes the point in its title: calcium scoring is an adjunct to risk stratification rather than a replacement for it. [5] Used to overrule a clinical picture it can mislead. Used to break a genuine tie in the intermediate band, it is the best instrument available. ## The German constraint, which almost nobody explains Here is the part that changes how the omission should be read, at least in Germany, Austria and the rest of the EU operating under the same Euratom basis. Every CT examination in Germany requires a rechtfertigende Indikation, a justified indication, under §83 StrlSchG. A physician must establish, for that individual, that the health benefit of the examination outweighs the radiation risk. [6] [8] There is currently no recognised justified indication for standalone calcium scoring used purely as a screening test in an asymptomatic person. Screening applications of ionising radiation sit under a separate regime: §§84 and 14(3) StrlSchG permit them only after formal scientific assessment, with the federal ministry approving a screening type generically on the basis of a report from the Bundesamt für Strahlenschutz. [7] Calcium scoring has not been through that process. The practical consequence is that a German clinic cannot lawfully put a coronary calcium score on a menu as a routine component of a preventive package, however much a customer wants one and however good the guideline evidence is. [9] What a clinic can do is assess whether an individual indication exists and arrange the scan on that basis. This deserves stating plainly because the alternative reading, that German providers are simply behind, is wrong. The regulator has taken a stricter view of population radiation exposure than the American guideline process has, and the market is complying with it. Whether that view is correct is a legitimate argument. It is not a gap in the product. ## Where the premium market sits Among the CT-capable American programmes, Biograph offers CT coronary angiography, a more extensive study than calcium scoring alone, and Fountain Life includes advanced cardiac imaging in its membership. Neither operates under the German framework. In Germany, YEARS in Berlin handles it the way the law requires: cardiac CT is available as an add-on where individual medical indication supports it, rather than being included as standard in every programme. Its routine cardiovascular work runs through ergospirometry, arterial stiffness measurement, ankle-brachial index, 12-lead ECG and cardiac and vascular ultrasound, [10] which covers functional capacity and vascular status, ground a calcium score does not touch. It does not produce the specific number the cholesterol guideline references, and under §83 it cannot, absent an indication. The MRI-based providers face a second constraint on top of the legal one. Calcium scoring requires CT, and a programme built on the argument that MRI involves no ionising radiation cannot deliver a CT-based test without giving up its own safety case. Prenuvo and the other imaging-led operators are in this position by design rather than by oversight. ## What to do about it If cardiovascular risk is your main concern and you are between 40 and 75 with intermediate calculated risk, raise a calcium score with a physician who can assess whether an indication exists for you. In the United States you can generally buy one directly and cheaply. In Germany the conversation is clinical rather than commercial, and a family history, an abnormal lipid profile or a borderline risk calculation is the sort of thing that supports an indication. If you are buying a broader programme, ask which cardiac assessment it includes and how that maps onto the guideline. A programme covering functional capacity, arterial stiffness and cardiac ultrasound is doing serious cardiovascular work even without a calcium score. A programme covering none of those and leaning on a lipid panel is doing what your statutory check-up already does. ## What would change the grade A randomised trial of calcium-guided against guideline-directed preventive therapy, with a major cardiovascular event endpoint, would move this to A. Given the size of the intermediate-risk population and the low cost of the scan, it is among the most feasible outstanding trials in preventive cardiology. It would also give the Bundesamt für Strahlenschutz the material it would need to assess calcium scoring as an approved screening application, which is the route by which the German position could change. ### References 1. 2018 AHA/ACC multisociety guideline on the management of blood cholesterol: coronary artery calcium recommendations for intermediate-risk adults. https://www.acc.org/Latest-in-Cardiology/Articles/2021/10/12/12/46/New-Evidence-Supporting-Selective-Use-of-Coronary-Artery-Calcium-Scoring 2. Utility of coronary artery calcium scoring in low-risk patients: the Multi-Ethnic Study of Atherosclerosis (MESA). https://pmc.ncbi.nlm.nih.gov/articles/PMC12557561/ 3. Warranty period of a calcium score of zero: comprehensive analysis from MESA. JACC: Cardiovascular Imaging. https://www.jacc.org/doi/10.1016/j.jcmg.2020.06.048 4. National Lipid Association scientific statement on coronary artery calcium scoring to guide preventive strategies for ASCVD risk reduction. Journal of Clinical Lipidology. https://www.lipidjournal.com/article/S1933-2874(20)30342-1/fulltext 5. Coronary artery calcium scoring: an adjunct to risk stratification, not a replacement for it. American Journal of Medicine. https://www.amjmed.com/article/S0002-9343(26)00208-1/fulltext 6. Die rechtfertigende Indikation nach dem geänderten Strahlenschutzrecht. RöFo / Thieme. https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-1752-7099.pdf 7. Wissenschaftliche Bewertung und rechtliche Zulassung von radiologischen Früherkennungsuntersuchungen in Deutschland. Die Radiologie. https://link.springer.com/article/10.1007/s00117-020-00758-3 8. Rechtfertigende Indikation: Grundlagen und Beispiele. Ärztliche Stelle Hessen / TÜV SÜD. https://www.tuvsud.com/de-de/-/media/de/aerztliche-stelle-hessen/pdf/broschueren-und-flyer/tuev-sued-erstellung-rechtfertigende-indikatoren-hessen.pdf 9. Qualitätskriterien für die Erbringung kardialer CT-Leistungen. Die Kardiologie. https://link.springer.com/article/10.1007/s12181-023-00599-z 10. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en ================================================================================ # DEXA is well evidenced for the thing nobody sells it for URL: https://www.baseline-media.com/articles/dexa-what-its-actually-for/ Section: Evidence Evidence grade: B Published: 2026-08-23 | Figures checked: 2026-09-07 Bone density scanning carries a guideline recommendation and moderate net benefit in older women. Premium programmes sell it as a body composition readout, which is a different test with a different evidence base. ### Key findings - The USPSTF recommends bone mineral density screening by DEXA for all women aged 65 and over, and for postmenopausal women under 65 with one or more risk factors, finding moderate net benefit. The recommendation was updated on the basis of new evidence across 28 publications. - For men, the USPSTF found insufficient evidence to make a recommendation either way. - Age is a stronger determinant of fracture than bone density. Older adults fracture at much higher rates than younger adults with identical BMD, because bone quality declines and falls risk rises. - The grade applies to bone density screening in the recommended population. Body composition by DEXA is a separate use with good measurement precision and no outcome evidence for serial tracking in healthy adults. ### Questions answered **Is a DEXA scan worth it?** For bone density in the recommended population, yes: the USPSTF finds moderate net benefit for women 65 and over, and for postmenopausal women under 65 with a risk factor. For body composition tracking in a healthy adult, the scan measures precisely but no outcome evidence supports repeating it. Those are two different purchases that happen to use the same machine. **Who should get a bone density scan?** All women aged 65 and over, and postmenopausal women under 65 who have at least one osteoporosis risk factor such as low body weight, smoking, prior fracture, glucocorticoid use, parental hip fracture or excess alcohol. For men the USPSTF found insufficient evidence to recommend for or against screening, which does not mean men never need it, only that population screening is unproven for them. **Is DEXA accurate for body fat percentage?** It is precise and reproducible, and generally treated as a practical reference standard outside research settings. Precision is not the issue. The open question is whether knowing your body fat percentage to a decimal place, and watching it move, leads to a better outcome than the cheaper measurements you would otherwise use. No trial has tested that. **Does a good bone density result mean I will not fracture?** No, and this is the most misread part of the result. Age is a stronger determinant of fracture than bone density: older adults fracture at much higher rates than younger adults with the same BMD, because bone quality declines with age and falls become more likely. A BMD number belongs inside a fracture risk assessment such as FRAX rather than standing on its own. DEXA is one of the few tests in a premium health programme with a formal guideline recommendation behind it. It is also, in that setting, almost always sold for a purpose the guideline says nothing about. Both of those statements are worth unpacking, because the gap between them is where the money goes. ## The well-evidenced use The US Preventive Services Task Force recommends bone mineral density screening by DEXA for all women aged 65 and over, and for postmenopausal women under 65 who carry one or more osteoporosis risk factors, finding moderate net benefit in both groups. [1] The recommendation was strengthened to specify DEXA on the basis of new evidence reported across 28 publications. [2] That is about as good as preventive testing gets: a named modality, a defined population, a stated magnitude of benefit, and a route from the result to a treatment that reduces fractures. For men, the Task Force found insufficient evidence to recommend for or against. [1] This is frequently misreported as men not needing bone scans. It means population screening is unproven in men, not that an individual man with glucocorticoid exposure or a prior fragility fracture should not be scanned. ## The number is weaker than it looks One nuance in the evidence deserves more attention than it gets, because it changes how a normal result should be read. Bone density is an important fracture risk factor. Age is a stronger one. Older adults fracture at much higher rates than younger adults with identical bone mineral density, because bone quality declines independently of density and the probability of falling rises. [4] The practical consequence: a BMD figure in isolation is not a fracture probability. The Task Force points to fracture risk assessment tools such as FRAX, which combine density with age and clinical factors to produce a ten-year probability of a major osteoporotic event. [1] A programme handing over a T-score with no risk assessment around it has given you an input rather than an answer. > A reassuring T-score in a 70-year-old who falls is not reassurance. ## The use it is actually sold for Walk into a premium longevity programme and DEXA is rarely presented as osteoporosis screening. It is presented as body composition: fat mass, lean mass, visceral adipose tissue, regional distribution, a percentage to track. On measurement quality that is a reasonable thing to sell. DEXA is precise, reproducible, and treated as a practical reference standard for body composition outside research settings. Precision is not the problem. The problem is that no outcome evidence supports the use. Nobody has tested whether a healthy adult who tracks body fat percentage by DEXA every six months ends up healthier than one who uses a tape measure, a set of scales and a mirror. The measurement is better. Whether the better measurement produces a better decision is untested, and for most people the decisions available at that level of resolution are the same decisions available without it. There is a narrower case where it clearly earns its place. Somebody in a deliberate body recomposition programme, particularly while losing weight on a GLP-1 agonist, has a real question that scales cannot answer: how much of what I am losing is muscle. DEXA answers that, the answer changes the protein and resistance training prescription, and the change has its own evidence. That is a legitimate purchase with a defined question behind it. ## Why grade B Grade B means consistent evidence of benefit from trials with surrogate endpoints, single trials, or strong longitudinal cohorts. Bone density screening in the recommended population sits there comfortably, supported by a formal recommendation with moderate stated net benefit and a clear treatment pathway. It does not reach A because the chain from screening to fracture reduction runs through treatment decisions rather than a direct randomised test of screening itself, and because the benefit is confined to defined groups rather than adults generally. Following our own rule that a grade applies to a test for a stated purpose in a stated population, this B covers bone density screening in women 65 and over and in postmenopausal women under 65 with risk factors. It does not cover serial body composition tracking in healthy adults, which would be graded C on current evidence: precise, plausible, and untested against an outcome. ## What to ask a programme offering it Whether the report includes a FRAX or equivalent fracture risk assessment rather than a T-score alone. Whether you are in a population where bone density screening is recommended, and if not, what question the scan is answering instead. And whether it is being sold to you as bone health or as body composition, because the two share a machine and nothing else. ## What would change the grade For the bone density use, a randomised trial of screening against no screening with fracture as the endpoint would move it toward A, though the ethics of withholding a recommended test now make that unlikely to happen. For body composition, the tractable question is simpler and nobody has run it: randomise adults in a recomposition programme to DEXA-guided against scale-guided monitoring, and measure lean mass retention at a year. ### References 1. US Preventive Services Task Force. Screening for osteoporosis to prevent fractures: recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening 2. USPSTF boosts DEXA in osteoporosis screening. AuntMinnie. https://www.auntminnie.com/clinical-news/digital-x-ray/article/15712019/uspstf-boosts-dexa-in-osteoporosis-screening 3. US Preventive Services Task Force. Screening for osteoporosis: evidence summary. https://www.uspreventiveservicestaskforce.org/home/getfilebytoken/hhrqMCEgbsBMJ_Ppbcp4yJ 4. Screening for osteoporosis. NCBI Bookshelf, introduction and background. https://www.ncbi.nlm.nih.gov/books/NBK45204/ 5. Dual energy X-ray absorptiometry scanning for osteoporosis detection: analysis of patients at a tertiary care hospital. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544949/ ================================================================================ # Germany quietly became the cheapest place in the world to buy a serious health check URL: https://www.baseline-media.com/articles/germany-premium-checkup-market/ Section: Reporting Evidence grade: ungraded Published: 2026-08-20 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Preventicum, Lanserhof, Biograph, Fountain Life, Clinique La Prairie The same diagnostic workup that costs $7,500 in San Francisco and sits inside a €25,000 Swiss week is available in Berlin and Essen for between €1,400 and €1,900. The reasons have more to do with how German medicine bills than with anything a marketing department decided. ### Key findings - German private check-up pricing starts at a reported €1,400 at Preventicum in Essen and €1,900 at YEARS in Berlin, against $7,500 for Biograph's entry membership in the United States. - The German market splits between organ-targeted imaging on clinical indication, the older model, and whole-body imaging in a single day, the newer one. - Statutory Check-up 35 remains free every three years from age 35 and covers the cheapest high-yield measurements, which means every private euro spent in Germany is buying an increment rather than a baseline. - Reimbursement depends on private or supplementary cover and on whether individual items are billable under the GOÄ. Statutory insurees pay out of pocket for everything beyond the entitlement. ### Questions answered **How much does a private health check cost in Germany?** Reported and published figures run from about €1,400 at Preventicum in Essen to €1,900 for the entry programme at YEARS in Berlin, rising to €7,600 and €16,900 for the deeper YEARS tiers. Residential programmes are a different product: Lanserhof reports seven-night entry pricing from about €5,390 in Austria to €8,435 at Tegernsee, including accommodation. **Why is a health check cheaper in Germany than in the United States?** Imaging and laboratory costs are structurally lower, physician fees are constrained by the GOÄ fee schedule even in private practice, and the statutory system already covers the baseline measurements, so private providers compete on the increment rather than on the whole examination. Marketing and customer acquisition costs are also far lower than in the US direct-to-consumer market. **Is YEARS or Preventicum better?** They answer different questions. Preventicum works on an organ-targeted model, imaging what the clinical picture indicates, which is closer to guideline practice and produces fewer incidental findings. YEARS images the whole body and runs a much wider panel in one day, which produces a fuller baseline and more chances of finding something unresolved. Organ-targeted is the more conservative choice on the evidence; whole-body gives you more data. **Will private health insurance in Germany cover a preventive check-up?** Often partly. Privately insured patients and those with supplementary cover can frequently recover a portion depending on the policy and on whether individual items are billable under the GOÄ. Statutory insurees pay privately for anything beyond Check-up 35, because those items are individuelle Gesundheitsleistungen. An American buying a comprehensive annual health assessment pays $7,500 to enter at Biograph, or a reported $19,500 a year for Fountain Life's APEX membership. A Swiss equivalent, if you count the residential clinics, runs to a reported CHF 31,800 for a week at Clinique La Prairie. A German pays €1,400 in Essen or €1,900 in Berlin. The workup is not ten times smaller. This gap is not widely discussed, partly because German providers are bad at marketing internationally and partly because the country's private medical sector has historically served its own patients rather than an export market. It is becoming visible now because the Berlin end of the market has started publishing its prices in English. ## Two German models The older model is organ-targeted. Preventicum in Essen, one of the longer-running private check-up centres, builds packages around an internal medical examination, comprehensive laboratory diagnostics, 4D ultrasound and rest and stress ECG, with MRI of two organs where the clinical picture and prior agreement indicate it. [1] Reported packages run roughly €1,400 to €2,000. This is closer to guideline practice than anything else sold privately. Imaging follows indication rather than preceding it, which is how radiology is supposed to work and which produces markedly fewer incidental findings than scanning everything. It is also a harder product to sell, because "we will image what your history suggests" is less compelling than "we will image all of you". The newer model compresses everything into one day and tiers by modality. YEARS in Berlin sells Core at €1,900 over six hours: 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, a cognition test, lung function and body composition, and no imaging, no liquid biopsy and no genetics. Evolve at €7,600 adds 3T whole-body MRI and a multi-cancer liquid biopsy at 120-plus biomarkers. Ultimate at €16,900 adds genome sequencing, epigenetic clocks and microbiome analysis at 230-plus, with three annual physician check-ins. [6] To its credit, the Berlin operation says this out loud. Its Radical transparency section states that whole-body MRIs find abnormalities in many healthy people which would never have caused symptoms, publishes sensitivity, specificity and positive predictive value for its screening methods, and answers the question of whether the programme is study-backed with only partly, together with an undertaking to say where the evidence is thin. [7] Providers are not generally in the habit of publishing the limitations of what they sell. The two approaches disagree about something real. Organ-targeted imaging accepts that it will miss things in order to avoid manufacturing problems. Whole-body imaging accepts that it will manufacture some problems in order to miss fewer things. Our assessment of whole-body MRI screening remains grade C on the evidence, which means the second position is not vindicated by trial data. It also means the argument is live rather than settled, and a buyer choosing between them is making a genuine judgement rather than picking the better clinic. ## Why the prices are what they are Four structural reasons, none of which are about generosity. Imaging capacity is cheap in Germany relative to the United States. An MRI hour costs a fraction of the American equivalent, and the density of scanners means providers are not bidding for scarce slots. Physician fees are constrained even privately. The GOÄ fee schedule sets the terms for private billing, and while multipliers apply, the ceiling is far below what a US concierge practice charges for equivalent clinician time. The statutory system covers the baseline. Because Check-up 35 already provides blood pressure, lipids, glucose and a consultation free of charge every three years, [4] German private providers cannot sell those as the product. They have to sell the increment, and competing on increments disciplines pricing in a way that selling a whole examination does not. Customer acquisition is cheaper. The German market has no equivalent of the American direct-to-consumer health spend, and providers here have not had to price in the marketing budgets that the US memberships carry. ## The residential wing Germany also hosts the other end of the market. Lanserhof Tegernsee is the flagship of the residential method clinics, with reported seven-night entry pricing from €8,435 including accommodation and the Classic medical programme, [2] and Sylt from €6,480. LANS Medicum in Hamburg runs the same brand's outpatient check-ups without the residential element. [5] These belong in a different comparison. A week at Tegernsee is a behavioural intervention with medical supervision, and judging it by modality count misses what it is for. Someone who will genuinely change how they eat and sleep only when removed from their own life is buying something a six-hour diagnostic day cannot provide, and vice versa. ## What this means for someone outside Germany Medical travel for diagnostics is a smaller decision than medical travel for treatment. A single-day assessment requires one trip, produces a portable report, and carries none of the follow-up complications that make cross-border surgery difficult. The relevant question is whether the report will be usable by your own physician at home, which comes down to whether the imaging is on standard protocols and the laboratory work is accredited. On price alone the arbitrage is substantial. A Londoner or New Yorker comparing a €1,900 Berlin day against a $7,500 American membership entry is looking at a difference large enough to cover the flight several times over. Whether that person needs that many modalities at once is a separate question, and the honest answer for most healthy people under 45 is probably not. The German market's real advantage is that it makes the choice legible. Prices are published, the statutory baseline is known, and the two competing philosophies are both available at prices where you can afford to disagree with one of them. ### References 1. Preventicum, Essen. Diagnostikpakete. https://www.preventicum.de/diagnostikpakete.html 2. Lanserhof price comparison across Lans, Tegernsee and Sylt. Serenity Ways. https://www.serenityways.com/posts/compare-lanserhof-lans-tegernsee-sylt-prices 3. Biograph frequently asked questions, Core and Black membership contents. https://www.biograph.com/faq 4. Verbraucherzentrale. Früherkennung: Diese Vorsorgeuntersuchungen stehen Ihnen zu. https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/krankenversicherung/frueherkennung-diese-vorsorgeuntersuchungen-stehen-ihnen-zu-10429 5. LANS Medicum Hamburg. LANS Med Check-ups. https://www.lanserhof.com/en/hamburg/services/lans-med-check-ups 6. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en 7. YEARS Präventivmedizin, Berlin. “Radical transparency: the questions other providers would rather not answer”, homepage section (English and German editions). https://years.co/de ================================================================================ # Continuous glucose monitors for people without diabetes: one trial with an outcome URL: https://www.baseline-media.com/articles/cgm-in-non-diabetics/ Section: Evidence Evidence grade: C Published: 2026-08-16 | Figures checked: 2026-09-07 The sensor is accurate, the data is real, and the evidence that wearing one changes anything for a metabolically healthy adult rests on seven small studies, only one of which measured an outcome. ### Key findings - A systematic review of CGM in non-diabetic individuals for cardiovascular prevention, covering January 2020 to August 2025, found seven eligible studies. Six carried a low risk of bias. Only one dealt with an actual outcome measure. - The clearest positive result is narrow and useful: timing a walk to begin before the postprandial glucose peak significantly reduced post-meal glucose, insulin and C-peptide. - A 2026 systematic review concluded that CGM's effectiveness for glycaemic parameters, body weight and behavioural outcomes in non-diabetic people remains unclear. - Observational work links higher glycaemic variability to surrogate markers such as blood pressure variability, and detects subclinical dysregulation in menopause and obstructive sleep apnoea. These are associations, not demonstrated benefits of monitoring. ### Questions answered **Is a continuous glucose monitor worth it if you do not have diabetes?** For most metabolically healthy adults the evidence does not yet support it as a routine purchase. A systematic review covering 2020 to 2025 found only seven studies of CGM in non-diabetic people for cardiovascular prevention, and only one measured an actual outcome. The strongest finding is specific rather than general: using the sensor to time exercise before the post-meal glucose peak measurably lowered glucose, insulin and C-peptide. If you would use it that way for a few weeks and then stop, the case is reasonable. As a permanent subscription it is not established. **What is a normal glucose spike after a meal for someone without diabetes?** There is no clinically validated threshold for a healthy person, and this is the central problem with consumer CGM. Reference ranges used by consumer apps are largely derived from expert opinion or diabetic care targets rather than from outcome data in metabolically healthy adults. A rise after eating is normal physiology; there is no agreed figure above which it becomes pathological in someone with normal HbA1c and fasting glucose. **Does glucose variability predict heart disease in healthy people?** Observational studies link higher glycaemic variability to surrogate markers of cardiovascular risk, including blood pressure variability. That is an association with a surrogate, not evidence that reducing variability reduces events, and no trial has tested the latter in a metabolically healthy population. **Can a CGM help you lose weight?** A 2026 systematic review found the effectiveness of CGM for body weight and behavioural outcomes in non-diabetic people remains unclear. It does appear to work as a motivational device in some studies, increasing readiness for physical activity. Whether that motivational effect outlasts the novelty of the sensor is the question the literature has not answered. import Figure from '@/components/Figure.astro'; A continuous glucose monitor is a small sensor in the arm reporting interstitial glucose every few minutes. In type 1 diabetes it is transformative and the evidence is not in question. Sold to a metabolically healthy adult as a window into their metabolism, it becomes a different proposition, and the literature supporting that proposition is smaller than the marketing implies. A systematic review searched January 2020 to August 2025 for studies of CGM in non-diabetic individuals for cardiovascular prevention. It found seven. Six carried a low risk of bias, which is respectable. Only one dealt with an actual outcome measure. [1] Seven studies and one outcome is the whole evidential foundation of a product category currently sold by subscription. ## What the good result actually shows The clearest positive finding is worth taking seriously precisely because it is so specific. CGM was used to personalise the timing of exercise, starting a walk before the individual's own postprandial glucose peak rather than at a fixed interval after eating. This significantly reduced postprandial glucose, insulin and C-peptide. [1] That is a real effect from a real mechanism, and it is the sort of thing only continuous measurement can enable, because the peak arrives at a different time in different people. CGM also functioned as a motivational device, increasing readiness for physical activity. [1] Behavioural effects are easy to dismiss and probably should not be: a measurement that gets somebody walking after dinner has done more than most biomarkers. {[ { label: 'Studies identified', n: 7, color: 'var(--grade-b)' }, { label: 'Low risk of bias', n: 6, color: 'var(--grade-b)' }, { label: 'Measured an outcome', n: 1, color: 'var(--grade-d)' }, ].map((d, i) => ( {d.label} {d.n} ))} {[0,2,4,6].map((v) => ( {v} ))} ## The missing number Here is the question a consumer CGM cannot answer, and it is the one the whole product depends on. What is a normal glucose excursion after a meal in a metabolically healthy adult, and above what level does it matter? There is no clinically validated threshold. Consumer apps display target ranges and flag spikes, but those ranges derive largely from expert opinion or from diabetic care targets, not from outcome data in people with normal HbA1c and fasting glucose. A rise after eating is normal physiology. Without a validated cut-off, an app telling somebody their oatmeal caused a spike is reporting a number and inventing the interpretation. This is why the surrogate evidence, though genuinely interesting, does not close the gap. Observational work links higher glycaemic variability to surrogate markers of cardiovascular risk such as blood pressure variability, and detects subclinical dysregulation in menopause and in obstructive sleep apnoea. [1] Those associations may well be pointing at something real. They do not establish that watching your own variability and eating differently in response improves anything. A 2026 systematic review of CGM in non-diabetic populations put it plainly: effectiveness for glycaemic parameters, body weight and behavioural outcomes remains unclear. [2] ## Why grade C rather than D Grade C means mechanistically plausible and widely used, with no trial evidence of net benefit in the population being screened. Grade D would mean the measurement is unreliable or the inference unsupported. CGM does not belong in D, and the distinction is worth defending. The sensor measures what it claims to measure, the physiology is not in doubt, and there is at least one demonstrated mechanism by which the data changes a decision usefully. That is a better position than several more expensive things sold alongside it. What keeps it out of B is the absence of an outcome. One study with an outcome measure, in a literature of seven, is not a foundation for a permanent subscription. ## How to buy it, if you are going to Two framings, and only one of them survives the evidence. As a **time-limited experiment**, the case is reasonable. Two to four weeks, with a specific question: which of my regular meals produces the largest excursion, and does walking twenty minutes after that meal flatten it? That is close to the intervention the positive study tested, it produces an answer you can act on permanently, and then the sensor comes off. As a **continuous subscription** for a metabolically healthy adult, there is nothing in the literature to support it. You will accumulate a great deal of data with no validated threshold to interpret it against, and the most likely outcome is either that you ignore it or that you narrow your diet on the basis of numbers nobody can tell you are abnormal. ## What would change the grade A randomised trial in metabolically healthy adults, comparing CGM-guided lifestyle change against the same advice without a sensor, with HbA1c or incident dysglycaemia at twelve months. That trial is cheap by the standards of this field, the sensors are already manufactured at scale, and it would settle the question in a year. Separately, and more urgently: somebody should establish reference ranges for postprandial excursion in people without diabetes. Until that exists, every consumer app is flagging deviations from a range that was never validated for the person reading it. ### References 1. Use of continuous glucose monitoring in non-diabetic individuals for cardiovascular prevention: a systematic review of its impact on guiding lifestyle interventions. https://pmc.ncbi.nlm.nih.gov/articles/PMC12612783/ 2. Continuous glucose monitoring in non-diabetic populations: a systematic review of observational and interventional studies with meta-analysis. European Journal of Medical Research. 2026. https://link.springer.com/article/10.1186/s40001-026-03920-0 3. The efficacy of using continuous glucose monitoring as a behaviour change tool in populations with and without diabetes: a systematic review and meta-analysis of randomised controlled trials. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668089/ 4. Non-invasive continuous glucose monitoring in patients without diabetes: use in cardiovascular prevention, a systematic review. https://pmc.ncbi.nlm.nih.gov/articles/PMC11722592/ 5. Beyond diabetes: continuous glucose monitoring as a candidate precision tool for cardiovascular prevention and healthy longevity, a hypothesis-generating narrative review. https://pmc.ncbi.nlm.nih.gov/articles/PMC13515009/ ================================================================================ # What does 230 biomarkers buy you that 89 does not? URL: https://www.baseline-media.com/articles/what-230-biomarkers-buys/ Section: Comparison Evidence grade: C Published: 2026-08-13 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Function Health, Superpower, Fountain Life, Q Bio, Neko Health Panel size is the number every premium programme leads with and the one that tells you least. Some of the additional markers change decisions, most add precision to a picture you already had, and a few mainly add things to worry about. ### Key findings - Panel sizes in the Baseline Index run from about 70 datapoints at Neko Health to 230 at the top YEARS tier and 200-plus at Fountain Life. - The first 20 markers carry most of the decision weight. Lipids, HbA1c, kidney and liver function, thyroid, full blood count and inflammatory markers cover the majority of actionable findings in asymptomatic adults. - Marker count and marker value diverge sharply above roughly 60 analytes, because additional markers are increasingly either research-grade, highly correlated with markers already measured, or not actionable in an asymptomatic person. - The strongest argument for a large panel is not detection but baseline: knowing your own normal makes a future deviation interpretable in a way a population reference range cannot. ### Questions answered **How many biomarkers do you actually need in a health check?** For most asymptomatic adults, roughly 20 to 30 analytes cover the large majority of actionable findings: a lipid panel including ApoB where available, HbA1c or fasting glucose with insulin, creatinine and eGFR, liver enzymes, TSH, a full blood count, ferritin, vitamin D, and an inflammatory marker such as hs-CRP. Panels beyond about 60 add precision and baseline value rather than new categories of finding. **Is a 230-biomarker panel worth the extra money over an 89-biomarker panel?** It depends on what you want the result for. The additional markers rarely change what you do next in a healthy person, so as a detection exercise the marginal value is low. As a personal baseline the case is stronger: a wide panel measured once, when you are well, makes future changes interpretable against your own values rather than a population range. Buying breadth once and depth-of-follow-up thereafter is usually better value than buying maximum breadth repeatedly. **Which providers have the largest biomarker panels?** In the Baseline Index, the top YEARS tier in Berlin runs 230 biomarkers at €16,900, with 89 at its €1,900 entry programme and 120 in between. Fountain Life reports 200-plus. Q Bio runs 120-plus, Function Health and Superpower 100-plus each, and Neko Health about 70 datapoints. Panel size correlates with price and only loosely with clinical usefulness. **Can a large biomarker panel cause harm?** Indirectly, yes. With enough analytes, statistical chance alone will place some outside the reference range in a healthy person, and each flagged result invites follow-up. The harm is not the blood draw but the cascade: repeat tests, imaging, referrals and anxiety attached to findings that were never going to matter. A programme with a physician who contextualises the panel reduces this substantially, which is why supervision matters more than count. Every premium health programme leads with a number. Seventy datapoints. A hundred markers. Two hundred and thirty. The number is easy to compare, which is why it is the number they publish, and it correlates with price far more reliably than with anything a physician would act on. Panel sizes in the Baseline Index run from about 70 datapoints at Neko Health, through 100-plus at Function Health and Superpower and 120-plus at Q Bio, to 200-plus at Fountain Life and 230 at the top YEARS tier. YEARS is the useful case study because it publishes three panel sizes for the same underlying programme: 87 biomarkers at €1,900, 120-plus at €7,600 and 230-plus at €16,900. [1] Same clinic, same modalities, same day. The variable is isolated. So what does the increment actually buy? ## The first twenty markers do most of the work In an asymptomatic adult, a fairly short list covers the large majority of findings that change what happens next. A lipid panel, ideally including ApoB. HbA1c or fasting glucose with insulin. Creatinine with eGFR. Liver enzymes. TSH. A full blood count. Ferritin. Vitamin D. An inflammatory marker such as hs-CRP. These are cheap, well standardised, and attached to interventions with their own outcome evidence. They are also, with the exception of ApoB, insulin and hs-CRP, essentially what the German statutory check-up already provides free of charge. ## Between twenty and sixty, you buy resolution The next band is where a good panel earns its money in a way the first band cannot. Lipoprotein(a), measured once in a lifetime because it is genetically determined. Fasting insulin with HOMA-IR rather than glucose alone. Thyroid antibodies where TSH is borderline. Iron studies rather than ferritin in isolation. Homocysteine. Uric acid. A full lipid subfraction picture. None of these are exotic, and several answer questions the basic panel raises without resolving. This is the band where a wider panel changes management with reasonable frequency. ## Above sixty, the curve flattens Beyond roughly 60 analytes, additional markers tend to fall into three groups. Some are highly correlated with markers already measured, so they add confidence rather than information. Some are research-grade, meaning the association with outcomes exists at population level but no threshold triggers a defined action in an individual. And some are actionable in principle but not in an asymptomatic person, because the finding only means something in the presence of symptoms the patient does not have. This is where the honest answer to the headline question sits. Going from 89 to 230 markers in a healthy 45-year-old will rarely change what anybody does on Monday morning. > Panel size is a proxy for thoroughness that stopped tracking thoroughness > somewhere around the sixtieth analyte. ## The argument that does survive There is one, and it is not about detection. A wide panel measured once, while you are well, establishes your own reference range. Population reference intervals are constructed so that 95% of a reference population falls inside them, which means your personal normal may sit near an edge, and a future result drifting toward the middle of the population range could represent a real change in you that no threshold flags. Having 230 of your own values from a year when you felt fine is genuinely useful when something changes later. This reframes what a large panel is for. It is a baseline purchase, not a detection purchase. Bought that way, the logic points toward doing it once, thoroughly, reasonably early, and then tracking a much smaller set annually. It is worth noting that YEARS structures its tiers close to this line, and more deliberately than most. Its €1,900 Core programme is the biomarker-and-function tier: 87 analytes plus spiroergometry, echocardiography, vascular ultrasound, cognition and lung function, with no imaging, no liquid biopsy and no genetics. The one-off structural measurements sit above it, with whole-body MRI and a multi-cancer liquid biopsy at €7,600 and genome sequencing, epigenetic clocks and microbiome analysis at €16,900, where the panel reaches 230-plus. That ordering puts the repeatable measurements at the bottom and the buy-once measurements at the top, which is the right way round. ## Why this grades C Grade C means plausible and widely used with no trial evidence of net benefit in the screened population. Extended biomarker panels have never been tested against a limited panel for outcomes in asymptomatic adults. The theoretical case for personal baselines is sound and untested. The countervailing consideration is statistical and unavoidable. Measure enough analytes in a healthy person and chance alone puts some outside the reference range. Each one invites follow-up, and the follow-up carries the same cascade risk documented for incidental imaging findings. [4] The mitigation is a physician who reads the whole panel in context rather than a portal that colours 11 results amber, which is an argument for supervised programmes over mail-order testing regardless of panel size. ## What to ask instead of the count Which specific markers are included, in a published list, so you can check whether ApoB and Lp(a) are among them rather than assuming that 200 markers must include the useful ones. Who reads the result, and whether the same clinician sees the panel alongside the imaging and the functional testing. An integrated read is worth more than 100 extra analytes. What happens to a borderline value. A programme with a defined threshold for repeating rather than escalating is doing something a portal cannot. ## What would change the grade A trial randomising asymptomatic adults to a focused panel against an extended one, measuring downstream investigations, diagnoses and outcomes, would settle this. It would be inexpensive by trial standards and would probably not flatter the extended arm. ### References 1. YEARS. Programme comparison: Core, Evolve and Ultimate biomarker counts and modality coverage. https://years.co/en 2. Fountain Life memberships: CORE, APEX and APEX Family. https://www.fountainlife.com/membership 3. Full-body scans and preventive health: provider comparison. New Market Pitch, 2026. https://newmarketpitch.com/blogs/news/longevity-preventive-health-startup 4. O'Sullivan JW, et al. Prevalence and outcomes of incidental imaging findings. BMJ. 2018;361:k2387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249611/ ================================================================================ # Send the same stool sample to four companies and you get four different microbiomes URL: https://www.baseline-media.com/articles/microbiome-testing-evidence/ Section: Evidence Evidence grade: D Published: 2026-08-09 | Figures checked: 2026-09-07 Direct-to-consumer gut testing has a reproducibility problem large enough to invalidate the product. Variation between providers analysing identical samples is as large as the variation between different people. ### Key findings - In a 2026 analytical evaluation of direct-to-consumer gut microbiome services, variability between providers analysing the same material was on the same scale as the biological variability between different donors. - One company returned a replicate in which more than 50% of sequencing reads were unidentified, and still issued a consumer report from it. - There are no regulatory-approved clinical microbiome diagnostic tests. An international consensus statement on microbiome testing in clinical practice found the evidence for clinical usefulness scarce. - Clinicians report patients arriving for medical help on the basis of at-home microbiome results, which is the specific harm of selling an unvalidated test with a confident report attached. ### Questions answered **Are consumer gut microbiome tests accurate?** They are not reproducible enough to be called accurate. A 2026 analytical evaluation found that variability between direct-to-consumer providers analysing the same sample was on the same scale as the biological variability between different donors, attributed to methodological differences and insufficient quality control. One provider issued a consumer report from a replicate in which over half the sequencing reads were unidentified. **Is a microbiome test worth the money?** On current evidence, no. There are no regulatory-approved clinical microbiome diagnostic tests, the international consensus statement on microbiome testing in clinical practice describes the evidence for clinical usefulness as scarce, and the reproducibility data means your result depends substantially on which company you posted the sample to. The dietary advice these tests generate is generally advice that applies to almost everyone regardless of their microbiome. **Can a microbiome test tell me what foods to eat?** It can generate a food list, but the list is not reliably derived from your microbiome. Two problems compound: the composition measurement itself varies between providers as much as it varies between people, and the step from a composition reading to a personalised dietary recommendation rests on associations rather than demonstrated causation. Eat more fibre and more plant diversity is sound advice and does not require a test. **Is the gut microbiome important?** Almost certainly yes, and that is a separate question from whether a consumer test measures it usefully. The research field is serious and advancing. The gap is translational: disentangling correlation from causation, the absence of validated clinical thresholds, and no approved diagnostic. A field can be genuinely important while its consumer products are not yet worth buying. There is a straightforward way to test a test. Split one sample, post the halves to different laboratories, and see whether the answers agree. Somebody did this to the direct-to-consumer gut microbiome industry, and the results should end the category in its current form. A 2026 analytical evaluation published in Communications Biology assessed the performance of consumer gut microbiome testing services. The headline finding is the one that matters: variability between providers analysing the same material was on the same scale as the biological variability between different donors. [1] Read that again slowly, because it is easy to underweight. The difference between two companies looking at your gut is about the same as the difference between your gut and a stranger's. Which company you posted to carries roughly as much information as who you are. ## The quality control problem underneath it The evaluation attributed the spread to methodological variability and insufficient quality control rather than to anything inherent in sequencing. [1] Some companies produced consistent results across replicates. Others clearly did not. One detail deserves isolating. A provider returned a replicate in which more than 50% of sequencing reads were unidentified, and issued a consumer report from it anyway. [1] More than half the data was noise and the customer received a confident document describing their gut flora. That is not a measurement problem. It is a disclosure problem, and it tells you what the report is for. > The test does not know what it does not know, and the report is not designed > to tell you. ## What the clinical literature says The reproducibility finding lands on top of an evidence base that was already thin. There are no regulatory-approved clinical microbiome diagnostic tests. [1] The international consensus statement on microbiome testing in clinical practice concluded that evidence supporting clinical usefulness is scarce, and that commercial providers sell direct-to-consumer tests without proven value in practice. [3] Reviews of microbiome variability reach the same place from the methodological side: the difficulty of disentangling correlation from causation, limited clinician familiarity, and no established framework for clinical translation. [4] ## The harm is downstream, as usual The blood draw equivalent here is a stool sample, so the direct physical harm is nil. The documented harm is what people do with the report. Clinicians report patients seeking medical help on the basis of at-home microbiome results, [1] which is a particular problem when the underlying science is unsettled: a consultation that begins with an unvalidated result has to be spent dismantling it. Regulatory analyses of the category describe medical, economic and dignitary harms as the relevant categories, which is unusually blunt language for a policy paper. [5] There is also an opportunity cost that nobody itemises. Somebody spending several hundred euros on a microbiome panel has that money unavailable for measurements with outcome evidence, and there is a long list of those. ## Why grade D Grade D means marketed ahead of its evidence: measurement unreliable, or the claimed inference unsupported. Consumer microbiome testing satisfies both conditions, and the first one comprehensively. Scope matters, because the underlying science does not deserve this grade. Gut microbial ecology is a serious research field, the associations with metabolic and immune conditions are real, and therapeutic applications in defined conditions such as recurrent C. difficile infection are established medicine. The grade attaches to the consumer product: a posted sample, a composition readout of contested reproducibility, and a personalised dietary plan derived from it. ## What would change the grade Reproducibility first, and everything else second. If providers published replicate agreement statistics, the proportion of unidentified reads per sample, and their sequencing and bioinformatics pipeline, a buyer could distinguish the competent from the rest. Nothing about that requires new science, and no provider we are aware of publishes it. Beyond that, the field needs validated thresholds tied to defined clinical actions, and prospective evidence that acting on a microbiome result produces a better outcome than the generic advice it usually reduces to. Until then, the honest summary of what these tests recommend is: eat more fibre and a wider range of plants. That is good advice. It costs nothing, and it does not depend on what your report said. ### References 1. Evaluating the analytical performance of direct-to-consumer gut microbiome testing services. Communications Biology. 2026. https://www.nature.com/articles/s42003-025-09301-3 2. Direct-to-consumer microbiome tests prove wide variability. AGA / Gastroenterology news, April 2026. https://news.gastro.org/issues/2026/april-2026/dtc-microbiome-tests-prove-wide-variability/ 3. International consensus statement on microbiome testing in clinical practice. https://pubmed.ncbi.nlm.nih.gov/39647502/ 4. Navigating microbiome variability: implications for research, diagnostics, and direct-to-consumer testing. https://pmc.ncbi.nlm.nih.gov/articles/PMC12018463/ 5. Is the current regulatory framework for direct-to-consumer microbiome-based tests sufficient to protect consumers from medical, economic, and dignitary harms? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728816/ ================================================================================ # Your biological age result would have been different if you had eaten lunch URL: https://www.baseline-media.com/articles/biological-age-tests-reliability/ Section: Evidence Evidence grade: D Published: 2026-08-06 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Fountain Life Epigenetic clocks are the most technically reproducible biomarkers in consumer longevity testing and among the least biologically stable. Repeated-measures work shows the two properties are unrelated, and that the most trusted clocks are the worst offenders. ### Key findings - Repeated measures under ordinary short-term perturbations, including meals, stress and pollution exposure, produced substantial swings in epigenetic age estimates. Most clocks reached only moderate reliability at best. - Technical reproducibility did not predict biological stability. GrimAgeV2 and DunedinPACE, two of the most technically robust clocks available, were among the most biologically fragile. - SystemsAge and principal-component-based clocks were both technically stable and comparatively more biologically reliable. No consumer test makes this distinction visible to the buyer. - The clocks carry real prognostic signal at population level. DunedinPACE is associated with morbidity, disability and mortality, with effect sizes comparable to GrimAge. Population validity and individual usability are separate claims. ### Questions answered **Are epigenetic biological age tests accurate?** They are precise but not stable. Modern clocks such as DunedinPACE were built to exclude unreliable probes and show excellent technical reproducibility, so the same blood sample run twice gives nearly the same answer. Repeated sampling from the same person under ordinary conditions, such as after a meal or under stress, produces substantial variation. For a single result on a single day, that variation is large relative to the differences people act on. **Should I retest my biological age to see whether an intervention worked?** Not with the clocks currently sold to consumers. If one person's estimate moves by more than the intervention's plausible effect purely because of when the sample was drawn, a before-and-after comparison cannot distinguish a real change from noise. That is the specific inference these tests are marketed for and the specific inference the reliability data does not support. **Is DunedinPACE better than GrimAge?** For different purposes. Both show similar effect sizes for morbidity, disability and mortality in cohort studies, and both were among the most biologically fragile clocks in repeated-measures testing. Where stability under real-world conditions matters, the evidence currently favours SystemsAge and principal-component-based clocks. **What is the difference between technical and biological reliability?** Technical reliability asks whether the assay agrees with itself when the same sample is run twice. Biological reliability asks whether the result describes the person stably across ordinary conditions. A clock can be excellent on the first and poor on the second, and the recent evidence shows several widely used clocks are exactly that. An epigenetic clock estimates how fast you are ageing from patterns of DNA methylation in a blood sample. The good ones do this with impressive technical consistency. Run the same sample twice and you get almost the same number. This is the fact the industry quotes, and it is true. It is also the wrong reliability question. What a buyer wants to know is not whether the machine agrees with itself, but whether the number describes them stably enough that a change in it means something changed in them. A body of repeated-measures work has now answered that question, and the answer is uncomfortable. ## Two kinds of reliability, and only one is good Take repeated samples from the same person across ordinary conditions: before and after a meal, under acute stress, after exposure to air pollution. Nothing exotic, nothing that would plausibly alter the rate at which somebody ages over a lifetime. Under those perturbations, epigenetic age estimates fluctuate substantially, and most clocks reach only moderate reliability at best. [1] The finding that should reorganise how these tests are sold comes next. Technical reproducibility did not predict biological stability. The two properties came apart entirely. GrimAgeV2 and DunedinPACE, the clocks with the strongest technical credentials and the ones deliberately engineered around high-reliability CpG probes, were among the most biologically fragile. [1] DunedinPACE's own development paper documents its restriction to 173 CpG sites selected for high test-retest reliability, and it delivers exactly that. [2] The engineering worked. It simply did not buy the property that matters. SystemsAge and principal-component-based clocks came out both technically stable and comparatively more biologically reliable. [1] No consumer product we are aware of puts that distinction in front of the person paying for the test. ## The inference that breaks At population level these clocks are not junk, and calling them that would be lazy. DunedinPACE is associated with morbidity, disability and mortality, with effect sizes in the same range as GrimAge. [2] It predicts incident metabolic syndrome in the Berlin Aging Study II [5] and tracks accelerated cognitive ageing in the Framingham cohort. [4] Across thousands of people the signal is real and points the right way. The problem lies in the step from there to the product. A cohort association tells you that a group with faster clocks does worse than a group with slower ones. It does not license the two inferences these tests are actually bought for: that this is my pace of ageing, and that my pace of ageing improved because of what I did. The second is the expensive one. Retesting to evaluate an intervention requires measurement error to be small relative to the effect you are hunting. If the estimate moves materially depending on whether the draw happened before or after lunch, a six-month comparison cannot separate signal from sampling. You will get a number. It will be a different number. Neither you nor the company that sold it to you will know why. > These are honest instruments being asked a dishonest question. Almost nothing > in how they are marketed reflects the difference. ## Why grade D Grade D means marketed ahead of its evidence, with unreliable measurement or an unsupported inference. Consumer biological age testing manages both at once, which is rare. The scope of the grade matters, because the researchers building these tools deserve better than a blanket dismissal. The underlying science is serious and improving, and recent reviews mapping clocks from laboratory to lifestyle applications are candid about the translation gap. [3] The grade attaches to the commercial product: a single-timepoint estimate sold to an individual with an implied promise that the number is theirs and that they can move it. ## Where these clocks are being sold The grade above applies to a single-timepoint estimate sold direct to an individual. It is worth being specific about where that leaves the clinical programmes, because several of them include the same instruments. Epigenetic clocks appear in the upper tiers of the premium screening market. The €16,900 Ultimate programme at YEARS in Berlin lists DunedinPACE and GrimAge by name, which are precisely the two clocks that came out most biologically fragile in the repeated-measures work above. [6] Fountain Life and other membership programmes include comparable epigenetic panels. Two things follow, and they pull in different directions. A clock inside a supervised programme is a different object from a mail-order result. It arrives next to 230-plus biomarkers, imaging and a physician who can say what weight to put on it, which is the context that stops a noisy number becoming a decision. YEARS also publishes a transparency section stating that it discloses sensitivity, specificity and positive predictive value for its screening methods and will tell patients where the study evidence is thin. [7] A provider that includes a weakly-evidenced measure while saying out loud that the evidence is weak is in a coherent position. That is not the same as the marketing problem this article describes. The grade does not move, though. Including DunedinPACE at the top of a price list implies the number is worth €9,300 more than not having it, and on the reliability evidence it is not. If these clocks are being sold as context rather than as findings, the honest presentation is to report them with their within-person confidence interval and to state that they are not suitable for tracking whether an intervention worked. We would regrade any programme that did. ## What would change the grade Three things, none requiring a scientific breakthrough. Report a confidence interval. Every clock has a known within-person variance under ordinary conditions and every result could carry one. "Your pace of ageing is 1.08, 95% CI 0.94 to 1.22" is harder to sell and far more honest than "1.08". Standardise the draw. Fasting state, time of day and recent acute stress are all controllable. Almost nobody controls them, because controlling them is inconvenient for a mail-order business model. Disclose and switch the clock. If SystemsAge and PC-based clocks are more biologically stable, consumer tests should use them and should state which clock produced the result. Many disclose nothing. Until at least the first of those arrives, treat a biological age result as a conversation piece and price it accordingly. Be sceptical of any programme that uses one as a headline outcome measure, because that is a claim about sensitivity to change and the sensitivity is not there. ### References 1. Biological versus technical reliability of epigenetic clocks and implications for disease prognosis and intervention response. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC13418614/ 2. Belsky DW, et al. DunedinPACE, a DNA methylation biomarker of the pace of aging. eLife. 2022;11:e73420. https://elifesciences.org/articles/73420 3. From the lab to lifestyle: epigenetic clocks in personalized aging and health. Biogerontology. 2026. https://link.springer.com/article/10.1007/s10522-026-10447-8 4. Faster DunedinPACE is associated with accelerated cognitive aging among older adults in the Framingham Heart Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710093/ 5. Epigenetic pace of aging (DunedinPACE) predicts incident metabolic syndrome in the Berlin Aging Study II (BASE-II). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11691513/ 6. YEARS Präventivmedizin, Berlin. Programme pricing and per-tier contents, Ultimate tier. https://www.years.co/de/was-kostet-ein-longevity-check-up 7. YEARS Präventivmedizin, Berlin. “Radical transparency: the questions other providers would rather not answer”, homepage section (English and German editions). https://years.co/en ================================================================================ # Eleven red flags in longevity clinic marketing, and how to check each one URL: https://www.baseline-media.com/articles/longevity-clinic-red-flags/ Section: Guide Evidence grade: ungraded Published: 2026-08-03 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Lanserhof, Clinique La Prairie, Fountain Life, Q Bio, Prenuvo, Neko Health, Biograph None of these require medical knowledge to test. Every one can be checked from a clinic's own website before you speak to anybody, and most of the category fails at least three. ### Key findings - Six of the sixteen providers in the Baseline Index do not publish a price. Non-disclosure is a decision about your negotiating position, not an administrative gap. - Ask whether the clinic mentioned any risk or uncertainty before it mentioned price. If not, that is information too. - A programme selling both the diagnosis and the treatment it justifies has an incentive gradient that runs one way, regardless of anyone's intent. - The single strongest good-faith signal available is a provider publishing the sensitivity, specificity and positive predictive value of its own screening tests. Almost nobody does. ### Questions answered **How do I choose a longevity clinic?** Check five things on the website before contacting anybody: whether the price is published per tier, whether the clinic states its incidental-finding rate, whether a named physician owns the follow-up, whether it discloses test performance figures such as sensitivity and specificity, and whether it makes any survival or mortality claim for whole-body MRI. The last one should be absent, because no trial supports it. A clinic that clears the first four is in a small minority. **What are red flags in a longevity clinic?** Unpublished prices. Biological age presented as a finding rather than a rough trend marker. Diagnosis and treatment sold by the same business. No stated incidental-finding rate. No named physician owning follow-up. Test performance undisclosed. Mortality claims for whole-body MRI screening. Free scans given to press or influencers. No corrections mechanism. Upsells introduced only after the initial consultation. Evidence claims citing studies that do not support them. **Why do some longevity clinics not publish their prices?** Because the consultation is where the price gets decided. A clinic that will not tell you what a programme costs before you speak to a salesperson has made a choice about your negotiating position. In the Baseline Index, Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi, Q Bio and Fountain Life's lower tiers publish no comparable figure, and Lanserhof publishes its prices only inside downloadable PDF brochures. **Should I trust a clinic that says its own tests have limited evidence?** It is the strongest signal available, and it is rare. A provider that publishes the sensitivity, specificity and positive predictive value of its screening methods, and states where the study evidence is thin, is handing you the tools to argue with it. That is the opposite of what marketing normally does, and it costs the provider something to do. Every item below can be checked from a clinic's own website, in about fifteen minutes, without knowing any medicine. They are ordered by how much they tell you, and the first one tells you the most. ## 1. The price is not published Six of the sixteen providers in our Index do not publish a price. Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi, Q Bio and Fountain Life's lower tiers all require contact first. Lanserhof publishes prices, but only inside downloadable PDF brochures. [4] **How to check:** look for a price page with per-tier figures. Not "from", not "contact us for pricing", not a brochure download. **Why it matters:** a business that will not tell you the price before a consultation has decided the consultation is where the price gets set. That is a choice about your position, and it correlates with everything else on this list. ## 2. Biological age is a headline outcome If a clinic leads with a biological age number, or advertises that its patients reduced theirs, it is making a claim about instrument sensitivity that the instrument does not support. Repeated-measures work shows epigenetic clock estimates fluctuate substantially with meals, acute stress and pollution exposure, and that the most technically robust clocks are among the most biologically fragile. [2] **How to check:** is a biological age figure on the homepage or in a results testimonial? Does the clinic state which clock it uses, and its within-person confidence interval? **Why it matters:** as context inside a supervised programme, an epigenetic clock is defensible. As a headline outcome or a before-and-after result it is not, because the measurement cannot reliably detect the change being claimed. ## 3. Diagnosis and treatment sit in the same business Where the entity interpreting your scan also sells the intervention your scan justifies, the incentive gradient runs one way. This does not require anyone to act in bad faith; the structure produces more findings and more treatment regardless of intent. **How to check:** does the clinic sell therapies, infusions, supplements or hormone programmes alongside its diagnostics? If a finding pointed somewhere they do not treat, who would you be referred to? **Why it matters:** diagnostic-only models and externally referred treatment remove a judgement call you would otherwise have to trust. It is one dimension on which the cheapest provider in the category often beats the most expensive. ## 4. No stated incidental-finding rate Roughly one person in three scanned with whole-body MRI leaves with a finding that is either critical or unresolved: pooled prevalence is 13.4% for potentially serious findings and 32.1% once indeterminate ones are counted. [1] A clinic performing hundreds of scans a year knows its own number. **How to check:** search the site for "incidental". If the only mention is reassuring, that is not the same as disclosing a rate. **Why it matters:** this is the main documented harm of the product. Learning about it after your report arrives is not informed consent. ## 5. Nobody is named as owning the follow-up **How to check:** are the physicians named, with credentials and registration? Does the material say who contacts you if something appears, and what happens next? **Why it matters:** the difference between a defensible imaging programme and an indefensible one is mostly the apparatus around the scan. A PDF and a suggestion to see your GP is the failure mode. ## 6. Test performance is not disclosed Sensitivity, specificity and positive predictive value determine what a result actually means. A multi-cancer blood test with 39% all-cancer sensitivity is a useful supplement and a poor reassurance product, and you cannot know which you are being sold without the figures. **How to check:** does any page give sensitivity and specificity for the screening tests on offer? **Why it matters:** this is the strongest good-faith signal in the category precisely because it is costly to give. YEARS in Berlin publishes a section stating that it discloses sensitivity, specificity and positive predictive value for its screening methods, that whole-body MRI finds abnormalities in many healthy people which would never have caused symptoms, and that asked whether the programme is study-backed the answer is only partly. [6] We have not found an equivalent disclosure elsewhere in the Index, which says more about the category than about any one provider. ## 7. A mortality or survival claim for whole-body MRI **How to check:** look for "could save your life", "catch cancer before it spreads", or survival statistics presented next to the scan. **Why it matters:** no randomised trial has shown that whole-body MRI screening reduces mortality in asymptomatic adults. [3] The claim is not merely unproven, it is the specific thing the literature has failed to establish across a decade of asking. ## 8. Free scans for press and influencers **How to check:** search for reviews. Does the reviewer state whether they paid? Does the clinic's press page offer complimentary assessments? **Why it matters:** a review of a free five-figure programme is advertising with extra steps. The clinic knows this, which is why the scan was free. ## 9. No corrections mechanism **How to check:** is there any route to challenge a figure or a claim, and any record of the clinic having changed something? **Why it matters:** organisations that never correct anything are not error-free. ## 10. The upsells arrive after the consultation **How to check:** ask directly what the median total invoice is, as opposed to the advertised programme price. In residential programmes especially, physicians commonly recommend additional treatments after the initial consultation and the final bill moves accordingly. **Why it matters:** an advertised price you cannot actually pay is not a price. ## 11. Evidence claims that cite studies not saying that The hardest one to check and the most revealing. Pick one confident claim, follow it to the citation, and read the abstract. **How to check:** look for the gap between a population statistic and an individual-test claim. "Prevention reduces cardiovascular death by 80%" is about prevention broadly, not about the scan being sold beside it. Conflating the two is the most common move in the category, and YEARS is unusual in naming the problem on its own site: the big prevention statistics demonstrate the value of prevention and lifestyle overall rather than automatically that of each individual screening test. [6] **Why it matters:** a provider willing to stretch a citation in marketing is telling you how it will present your results. ## How to use the list Nobody passes all eleven, and a clinic failing one is not disqualified. The pattern is what matters: a provider that publishes prices, names its physicians, discloses test performance and declines to claim a mortality benefit is operating differently from one that does none of those, and the difference has nothing to do with price. One question compresses most of the list, and it comes from the consumer-guide literature rather than from us. Did the clinic mention any risk or uncertainty before it mentioned price? [5] If not, that is information too. ### References 1. O'Sullivan JW, et al. Prevalence and outcomes of incidental imaging findings on brain and body MRI of apparently asymptomatic adults. BMJ. 2018;361:k2387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249611/ 2. Biological versus technical reliability of epigenetic clocks and implications for disease prognosis and intervention response. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC13418614/ 3. Kwee RM, Kwee TC. Whole-body MRI for preventive health screening: a systematic review. Journal of Magnetic Resonance Imaging. 2019. https://pubmed.ncbi.nlm.nih.gov/30932247/ 4. Lanserhof. Prices page, brochures published as PDF only. https://lanserhof.com/en/prices/ 5. Consumer guide to comparing longevity clinics: features, prices and red flags. Longevity Fit Life. https://longevityfit.life/blog/en/consumer-guide-to-comparing-longevity-clinics-features-prices-and-red-flags 6. YEARS Präventivmedizin, Berlin. “Radical transparency: the questions other providers would rather not answer”, homepage section (English and German editions). https://years.co/en ================================================================================ # The best-evidenced number in any premium health check is the one nobody markets URL: https://www.baseline-media.com/articles/vo2-max-the-best-evidenced-number/ Section: Evidence Evidence grade: B Published: 2026-07-30 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Biograph, Everlab, Neko Health, Prenuvo, Fountain Life Cardiorespiratory fitness predicts all-cause mortality more powerfully than almost anything else a clinic can measure, with no observed upper limit of benefit. It is also cheap, unglamorous, and buried on page four of most programme brochures. ### Key findings - In 122,007 adults undergoing treadmill exercise testing at the Cleveland Clinic, with median follow-up of 8.4 years, the least-fit group had roughly five times the all-cause mortality of the elite-fit group. - Fitness was inversely associated with long-term mortality with no observed upper limit of benefit. Performance at two or more standard deviations above the age and sex mean carried the lowest adjusted mortality of any group. - The benefit held in older patients and in those with hypertension, the two groups most often advised to be cautious about hard exertion. - A cardiopulmonary exercise test costs a fraction of a whole-body MRI and is included by fewer than half the providers in the Baseline Index. ### Questions answered **How strongly does VO2 max predict lifespan?** In the largest analysis available, covering 122,007 adults with a median 8.4 years of follow-up, the least-fit group had approximately five times the all-cause mortality of the elite-fit group after risk adjustment. The association was inverse and continuous, with no observed upper limit of benefit, meaning the fittest participants had the lowest mortality rather than plateauing. **Is a cardiopulmonary exercise test worth having in a health check?** On the strength of the underlying evidence, it is among the best-supported measurements available in a preventive programme. Cardiorespiratory fitness has larger and more consistent mortality associations than most biomarkers, it is modifiable through training, and repeat testing can detect real change, which is not true of several more heavily marketed measures. **Which screening programmes include a VO2 max or CPET test?** In the Baseline Index, ergospirometry or a cardiopulmonary exercise test is included by YEARS in Berlin, notably in its €1,900 Core tier rather than only the expensive ones, by Biograph in both memberships, by Fountain Life, by Everlab and by Preventicum. Neko Health, Prenuvo, Function Health, Superpower and OneMRI do not include one. **Does measuring VO2 max actually improve outcomes?** The evidence establishes that fitness predicts mortality, not that measuring it changes outcomes. No randomised trial has tested whether telling someone their VO2 max leads to longer life. That gap is why this grades B rather than A, and it applies to every prognostic measurement sold in preventive medicine. Preventive medicine sells resolution. Whole-body MRI, 230 biomarkers, 170 genes, tumour DNA in blood. The measurement with the strongest mortality evidence behind it involves a mask, a bicycle and about twenty minutes of discomfort, and it appears in roughly half the programmes we have catalogued. Cleveland Clinic researchers analysed 122,007 adults who completed treadmill exercise testing between 1991 and 2014, following them for a median of 8.4 years. [1] Cardiorespiratory fitness was inversely associated with all-cause mortality across the whole distribution. The least-fit group carried roughly five times the death risk of the elite-fit group after adjustment. Two features of that result matter more than the headline ratio. ## There is no ceiling Most risk factors plateau. Blood pressure below a certain point stops buying you anything, and there is a point past which lowering LDL further produces diminishing returns. Fitness did not behave that way. Extreme cardiorespiratory fitness, defined as two or more standard deviations above the mean for age and sex, was associated with the lowest risk-adjusted all-cause mortality of any performance group, with no observed upper limit of benefit. [1] ## The benefit held where caution is usually advised The association persisted in older patients and in those with hypertension. These are the two groups most often counselled toward moderation, and in this dataset they were the groups where high fitness was associated with the largest survival difference. [1] > Fitness is the only variable in a premium health check that is both strongly > prognostic and reliably modifiable. Almost everything else is one or the other. ## Why this grades B rather than A Grade A requires replicated randomised evidence of benefit on a hard outcome. What exists here is observational, from very large cohorts with long follow-up and consistent effects, which is grade B territory in our scheme. The distinction is worth being precise about, because it is the same distinction that limits every other measurement in preventive medicine. The evidence establishes that fitness predicts mortality. It does not establish that measuring fitness improves mortality. Nobody has randomised people to being told their VO₂ max. What separates this from a whole-body MRI is that the downstream action is obvious, the action has its own trial evidence, and the measurement is sensitive enough to show whether the action worked. None of those three things is true of most of the panel. ## What this says about how programmes are built Fewer than half the providers in the Baseline Index include a cardiopulmonary exercise test. Among those that do, YEARS in Berlin is the clearest case: it places spiroergometry in the €1,900 Core programme, the tier that contains no imaging, no liquid biopsy and no genetics. [4] In other words the cheapest thing it sells is built around the best-evidenced measurement in the category, and the expensive modalities sit above it. Biograph includes VO₂ max in both memberships, as do Everlab in Melbourne, Fountain Life, and Preventicum in Essen. The imaging-led providers, including Prenuvo and OneMRI, do not, which follows from what they are: imaging businesses. Neko Health, whose entire pitch rests on measuring the well-evidenced things cheaply, does not include it either, which is the more surprising omission. The pattern says something about how these programmes get designed. A CPET costs a fraction of an MRI and is harder to photograph. It requires a technician, twenty minutes of a patient's maximal effort, and a physician who can interpret a ventilatory threshold. It does not produce an image anyone wants to look at. If you are choosing between two programmes at a similar price and one includes ergospirometry, that is a reasonable tiebreaker, and a better one than the biomarker count. It is also the question worth asking of any entry tier: a €1,900 programme with a cardiopulmonary exercise test in it is doing more evidenced work than a €1,900 programme with a scan in it. ## What would change the grade A randomised trial of fitness testing plus a structured exercise prescription against usual care, with a mortality or major cardiovascular event endpoint, would move this to A given the effect sizes already observed. Such a trial is feasible, considerably cheaper than an imaging trial, and nobody is running it. ### References 1. Mandsager K, et al. Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open. 2018;1(6):e183605. https://pubmed.ncbi.nlm.nih.gov/30646252/ 2. Mandsager K, et al. Full text, Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. https://caringambassadors.org/wp-content/uploads/2018/10/Mandsager_2018_Exercise_Mortality.pdf 3. Impact of cardiorespiratory fitness and diabetes status on cardiovascular disease and all-cause mortality: an NHANES retrospective cohort study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11059329/ 4. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en ================================================================================ # Three theories of the annual check, and the one the evidence likes least URL: https://www.baseline-media.com/articles/three-theories-of-the-annual-check/ Section: Comparison Evidence grade: ungraded Published: 2026-07-23 | Figures checked: 2026-09-07 Organisations discussed: Neko Health, Prenuvo, YEARS, Biograph, Function Health, Superpower, Fountain Life, OneMRI Neko bets on frequency, Prenuvo on imaging, and the depth clinics on a single exhaustive day. These are not price tiers of one product. They are different theories of what preventive medicine is for. ### Key findings - Entry prices in the category span two orders of magnitude, from £299 at Neko Health to roughly $19,500 a year at Fountain Life, for products sharing almost no modalities. - Neko has completed over 100,000 examinations without an MRI. Prenuvo has completed over 170,000 scans that are almost entirely MRI. Both cite volume as validation of opposite strategies. - The depth model has the strongest per-visit diagnostic yield in the category and the weakest case for annual repetition, because most of what its expensive modalities measure does not change yearly. - OneMRI at A$2,990 for an unbundled whole-body scan is the useful yardstick: it shows what the imaging alone costs, and therefore what everyone else's bundle is charging for. ### Questions answered **Is a cheap annual health scan better than an expensive one every few years?** It depends on which conditions you are trying to catch. Frequency wins for things that change fast and are cheap to measure, such as blood pressure, lipids, glucose and skin lesions. Depth wins for things that are structurally hidden and expensive to look for once, such as an aortic aneurysm, a renal mass or a coronary calcium burden. Neither model dominates. **Why do preventive screening prices range from £299 to $19,500?** Because these are not the same product. The £299 tier buys a blood panel, an optical skin scan and cardiovascular sensors. Mid-tier buys whole-body MRI. The upper tier buys multi-modal imaging, 200-plus biomarkers, genomics, liquid biopsy, functional testing and physician time. The range tracks modality count and clinician hours rather than quality. **Which preventive screening model has the best evidence behind it?** The cheap, frequent, guideline-aligned one, because it is closest to what randomised trials have actually tested: blood pressure, lipid and glucose measurement have decades of outcome evidence and whole-body MRI screening has none. That is uncomfortable for the imaging-led end of the market. It is not an argument that premium programmes contain nothing evidenced, and the distinction matters when choosing a tier: cardiorespiratory fitness testing carries one of the strongest mortality associations of anything measurable and appears only in the clinic-based programmes, not in the cheap sensor products. The best-evidenced package is a guideline-aligned panel plus a fitness test, which is a combination the statutory system does not offer and the cheapest private options do not either. **What is the best value preventive screening programme?** It depends which bundle you need, because the tiers gate modalities. For a programme containing both whole-body MRI and a multi-cancer blood test, YEARS Evolve at €7,600 is the cheapest we have found: the comparable American tier is Biograph Black at $15,000, since Biograph Core at $7,500 omits the blood test. For cheap annual measurement of the well-evidenced basics, Neko Health at £299 has no competitor. For functional testing without imaging, YEARS Core at €1,900 includes spiroergometry, which is the best-evidenced measurement in the category. It is tempting to read the preventive screening market as a ladder, with £299 at the bottom and €16,900 at the top, more money buying more medicine. That reading is wrong and it makes buyers spend badly. The market is three mutually exclusive arguments about what should be done to a healthy adult, and how often. ## Theory one: frequency beats depth Neko Health has completed more than 100,000 examinations and has never performed an MRI. [1] The omission is deliberate. The company built a proprietary optical scanner for skin, a cardiovascular sensor array and a blood panel, priced the result at £299, and reports that around three-quarters of members prepay their next annual visit. [3] The underlying claim is that most preventable death comes from a small number of slow, measurable processes, including rising blood pressure, drifting lipids, creeping glucose and a changing mole, and that the binding constraint is attendance rather than resolution. A modest panel measured every year, with a trend line, beats a magnificent panel measured once and forgotten. There is a real evidence advantage here that the company undersells. The measurements Neko takes are the measurements with outcome trials behind them. Nothing in the £299 product requires a leap of faith about screening efficacy, because blood pressure and lipid management have been tested for decades. It is the least scientifically adventurous product in the category, and that is its strength. ## Theory two: the image is the thing Prenuvo has run more than 170,000 scans across 29 clinics and now sells three memberships: Core at $1,199 with a focused scan and lab panel, Comprehensive at $2,499 with a whole-body scan and detailed labs, and Executive at close to $5,000 adding brain health and body composition. [4] Its first European clinic opened in London in 2025. Function Health bought its way into the same position by acquiring Ezra, and offers members an MRI at $899 across more than 170 partner imaging sites. [3] The claim is structural. Bloods describe physiology, but a renal mass, an aortic aneurysm or a pancreatic lesion is invisible to any panel and often lethal by the time it announces itself. Only anatomy shows anatomy. This is true, and it is also the theory with the weakest outcome evidence. No randomised trial has shown that whole-body MRI screening reduces mortality in asymptomatic adults, [5] and the incidental finding literature is unambiguous that a substantial minority of scanned people acquire a problem they did not arrive with. Imaging-led programmes make the most intuitively powerful argument in the category while standing on the least solid ground. For pricing the argument, OneMRI in Australia is the useful reference. At A$2,990 it sells the whole-body scan through a partner radiology network with a radiologist report and nothing else attached. That is roughly what the imaging costs unbundled, which tells you what everyone else is charging for the wrapper. ## Theory three: one exhaustive day The depth model treats the annual check as a comprehensive diagnostic episode rather than a measurement. YEARS in Berlin delivers it as a single supervised day of six to nine hours across three published tiers: €1,900 for 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, cognition and lung function and no imaging; €7,600 adding 3T whole-body MRI and a multi-cancer liquid biopsy at 120-plus biomarkers; €16,900 adding genome sequencing, epigenetic clocks and microbiome analysis at 230-plus, with three annual check-ins. [6] Biograph in San Francisco assembles a comparable stack, with MRI, DEXA, VO₂ max, genomics and CT coronary angiography available, at $7,500 for Core and $15,000 for Black. [3] The claim concerns interpretation. A biomarker means one thing beside an abnormal image and another beside a clean one. A genetic risk allele means one thing in isolation and another next to a calcium score. Assemble everything at once, under a physician who sees all of it, and you get inferences that no sequence of separate appointments produces. On per-visit diagnostic yield this is the strongest model in the market, and having a clinician on site who owns the follow-up addresses the biggest failure mode of imaging-led screening. The price comparison worth stating is narrower than a headline number, because the tiers gate modalities rather than only depth. Compare like with like: for a programme including both whole-body MRI and a multi-cancer blood test, YEARS Evolve is €7,600 and the nearest American equivalent is Biograph Black at $15,000, since Biograph Core at $7,500 excludes the MCED test. On that specific bundle the Berlin price is roughly half. At the entry level the two are not comparable at all: €1,900 buys no imaging in Berlin, while $7,500 in San Francisco does. Where the depth argument is weakest is repetition. Doing this once, in your forties, with a family history worth worrying about, has a decent case behind it. Doing it every year does not: your genome, your anatomy and your structural risk do not change annually, while the things that do change annually are the cheap ones. The depth programmes are effectively selling a baseline, and priced as a baseline, once or twice a decade with cheap annual monitoring in between, the model is easier to defend than as a subscription. The YEARS tiering fits that logic better than most, though not for the reason its marketing emphasises. Because imaging and genomics sit in the upper tiers, the €1,900 entry programme is repeatable annually without re-scanning anybody, and the one-off measurements are bought once at €7,600 or €16,900. Whether a buyer uses it that way is another matter, but the structure permits it. ## The membership variant Fountain Life sells CORE, APEX and APEX Family annual memberships, with APEX reported at roughly $19,500 to $21,500. [3] The diagnostic bundle is the most extensive in the Index. Diagnosis and in-house therapeutics sit within the same organisation, which suits people who want one team owning the whole pathway and means more of the interpretive judgement stays inside the business providing the treatment. Anyone weighing it should read the referral pathway carefully and ask what happens when a finding points somewhere the clinic does not treat. That structural question applies to every provider offering both diagnosis and therapy, and the fairest way to put it is that diagnostic-only models and externally referred treatment remove a judgement call the patient would otherwise have to trust. It is one dimension on which the cheapest provider in the category does well. ## What we would tell someone spending their own money Use the free statutory check first, wherever you live. Buy depth once, early enough that a baseline is worth having, from a physician-led programme that owns the follow-up rather than emailing a PDF. Then buy frequency, cheap and trended, for the decade afterwards. That sequence is not what anyone in the market sells, because it does not subscribe well. It is what the evidence supports. ### References 1. Neko Health company disclosures and reported examination volumes. Fierce Healthcare, 2026. https://www.fiercehealthcare.com/health-tech/full-body-scan-startup-neko-health-scores-700m-break-us-market 2. Neko Health vs Prenuvo vs Function Health: the race to build the AI-powered health check. Iatrox. https://www.iatrox.com/blog/neko-health-prenuvo-function-health-ai-powered-health-check 3. Full-body scans: which startup is ahead? New Market Pitch, 2026. https://newmarketpitch.com/blogs/news/longevity-full-body-scans-startup 4. Prenuvo prices whole-body MRI scans with other services. AuntMinnie. https://www.auntminnie.com/industry-news/market-analysis/news/15820463/prenuvo-prices-wholebody-mri-scans-with-other-services 5. Kwee RM, Kwee TC. Whole-body MRI for preventive health screening: a systematic review. Journal of Magnetic Resonance Imaging. 2019. https://pubmed.ncbi.nlm.nih.gov/30932247/ 6. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en ================================================================================ # Are longevity clinics worth it? A decision tree, not a verdict URL: https://www.baseline-media.com/articles/are-longevity-clinics-worth-it/ Section: Guide Evidence grade: ungraded Published: 2026-07-17 | Updated: 2026-09-07 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Neko Health, Prenuvo, Biograph, Fountain Life, Function Health The honest answer depends on facts about you rather than facts about the clinics. For most healthy adults with decent primary care the answer is no. For four specific groups it is yes, and this is how to tell which one you are in. ### Key findings - The case for getting assessed does not rest on feeling unwell. Several of the conditions that kill people are silent until they are advanced: roughly one adult in five carries an elevated lipoprotein(a) that no symptom will ever reveal, and hypertension, early kidney disease and atrial fibrillation are frequently asymptomatic. Feeling fine carries almost no information about any of them. - So the useful question is not whether to be assessed but what to be assessed for, and at what price. The measurements with the strongest outcome evidence are also among the cheapest, and most people have not had them. - Four groups have a case for buying depth beyond that: strong inherited risk, a decade or more without medical contact, several connected problems ordinary care has managed badly, and people who will act on a result they would otherwise ignore. - Price tracks modality count and clinician hours rather than quality. The most expensive programmes in Europe publish the least about what they diagnose, and the cheapest measurements have the longest outcome record. ### Questions answered **Are longevity clinics worth the money?** Getting assessed is worth it for almost everybody, because the conditions that matter most are silent: about one adult in five has an elevated lipoprotein(a) they will never feel, and hypertension, early kidney disease and atrial fibrillation are commonly asymptomatic. Whether a premium programme specifically is worth it depends on what you already have. If you have never used your statutory check and never had ApoB or Lp(a) measured, the cheapest tests are the highest-value ones and cost a few hundred euros. Beyond that, the strongest case for a comprehensive programme is a strong inherited risk, a decade or more without medical contact, or several connected problems ordinary care has handled badly. Buy the assessment; be deliberate about the tier. **Are longevity clinics a scam?** Mostly no, but the category contains a wide range. The diagnostics themselves are real medicine performed by licensed physicians. The problems are narrower and specific: biological age tests sold as findings rather than rough trend markers, mortality claims for whole-body MRI that no trial supports, and programmes that sell both the diagnosis and the treatment it justifies. A clinic that discloses its evidence limits and publishes its prices is a different proposition from one that does neither. **What is the cheapest useful preventive health check?** Your statutory entitlement, which is free in most European systems. Germany's Check-up 35 covers blood pressure, fasting glucose, a full lipid panel, urinalysis and a consultation every three years from age 35. A meaningful share of people buying five-figure programmes have never used it. After that, Neko Health at £299 is the cheapest credible private option, though it carries a reported six-figure waitlist. **How do I know if I need a longevity clinic or just a GP?** Ask what you would do differently with the result. If the honest answer is nothing, or if you already know you should sleep more and drink less and have not acted on it, a premium programme is unlikely to change that. If you have a specific unanswered question, such as a family history of a cancer that imaging can find, or a decade of unexplained symptoms nobody has connected, a comprehensive workup can answer something your GP has not. Start with the part the sceptical coverage of this industry tends to skip. The conditions most likely to shorten your life do not announce themselves. About one adult in five carries an elevated lipoprotein(a), which is entirely genetic, completely silent, and something the 2026 cholesterol guideline says should be measured at least once in every adult. [7] Hypertension, early kidney disease and atrial fibrillation are frequently asymptomatic too. Feeling well carries almost no information about any of them. So the honest answer to whether you should get assessed is yes, and it is not a close call. The interesting question is the next one: assessed for what, by whom, and at what price. That is where the industry's own answers stop being useful, because searching this question returns Fountain Life and Biograph writing about themselves. Nobody without a programme to sell had written it down, so the sellers did. Here is the version from somebody with nothing in the category. ## The question is about you, not about the clinics Most coverage treats this as a question about whether the diagnostics work. That is the wrong frame. The diagnostics mostly work, in the narrow sense that a 3T MRI produces a real image and a laboratory returns real numbers. Whether a programme is worth its price depends almost entirely on your starting position, because the value of information is a function of what you did not already know and what you will do about it. So: four questions, in order. ## 1. Have you used what you already have? Germany gives statutory insurees a free health check every three years from age 35, covering blood pressure, fasting glucose, a full lipid panel, urinalysis, a hepatitis screen and a consultation. [5] Most European systems have an equivalent. Cancer screening programmes sit alongside it, with their own eligibility rules. Those measurements are the cheapest high-yield tests in medicine, and they are free. A meaningful share of the people who enquire about five-figure programmes have not had them. If that is you, the highest-value preventive appointment available to you costs nothing, and buying a premium programme first is spending €7,600 to learn your cholesterol. **If you have not used your statutory entitlement, start there** and come back to this question with the results in hand. Not because a private programme is wrong, but because a €7,600 programme reading your cholesterol for the first time is paying a premium for something that was already free, and the numbers it returns are what tells you which tier you actually need. ## 2. What would you do differently with the result? This is the question that decides most cases, and almost nobody asks it before booking. If you already know you sleep badly, drink more than you should, and have not exercised properly since your thirties, a 230-biomarker panel will confirm it expensively. The information is not the binding constraint. Several thousand euros of diagnostics will not supply motivation that is not there, and the people who sell them know this even when their marketing implies otherwise. If, on the other hand, you are the kind of person who acts on data, and you know it because you have done it before, then a result that shifts your behaviour has a value that is genuinely hard to price. That is a real answer, and it is different from peace of mind. **If the honest answer is that you would do nothing differently,** the information is not your binding constraint and a larger panel will not become one. That is worth knowing before you spend, and it is a reason to spend differently rather than a reason to skip assessment: the cheap tests still answer the silent questions above, whatever you do with the rest. ## 3. Do you have an actual unanswered question? Four situations where a comprehensive programme earns its price, and they are reasonably specific. **Strong inherited risk.** A parent or sibling with early cardiovascular disease or a cancer that imaging can detect changes the arithmetic, because your prior probability is genuinely higher than the population average that guidelines are written for. This is the single best reason to buy depth. **A decade or more of avoidance.** People who have had no meaningful medical contact since their twenties are the group where comprehensive workups most often find something that matters, for the obvious reason that nothing has been looked at. **Several connected problems nobody has joined up.** Fatigue, disturbed sleep, creeping weight, borderline numbers on three separate visits to three separate doctors. Fragmented care handles this badly, and a single day where one physician sees everything at once is a structurally different service, not just a longer appointment. **A specific question with a specific test.** You want to know your Lp(a), because it is genetically determined, measured once in a lifetime, and about one person in five has a level that materially raises cardiovascular risk. Buy the test. You do not need the programme around it. **If none of these describe you,** the case for a comprehensive programme is weaker, and that is not a disappointing finding. It means the cheap things are working, and the sensible plan is the short list in section four rather than a five-figure package. Getting the silent measurements done still applies. ## 4. If you are buying, what should you buy? Now the clinics matter, and the category divides more sharply than its pricing suggests. The cheap end is the least scientifically adventurous and therefore the safest. Neko Health at £299 measures blood pressure, lipids, glucose and skin, which are the measurements with decades of outcome trials behind them, and declines imaging entirely. Nothing in it requires a leap of faith. The catch is a reported waitlist above 100,000 people and wait times of six to twelve months. The imaging end is the most intuitively compelling and has the weakest outcome evidence. No randomised trial has shown that whole-body MRI screening reduces mortality in asymptomatic adults, and roughly a third of scanned people leave with a critical or unresolved finding. [1] That does not make it worthless. It does mean anyone selling it to you on a survival claim has moved ahead of the literature. The depth end assembles everything into one supervised day, and this is where the interpretation happens. A biomarker means one thing beside a clean image and another beside an abnormal one. Whether that is worth several thousand euros depends on whether a physician actually reads it all together, which is the question to ask before booking rather than after. ## Two things to check on any price list **Where the modalities sit.** Programmes tier by modality, not only by depth, and the marketing rarely makes this obvious. YEARS in Berlin is a useful worked example because it publishes the breakdown: Core at €1,900 buys 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, cognition and lung function, and contains no imaging, no liquid biopsy and no genetics. Whole-body MRI and a multi-cancer blood test arrive at €7,600. Genome sequencing and epigenetic clocks arrive at €16,900. [6] Biograph in the US works the same way, holding its multi-cancer blood test back for the $15,000 tier rather than the $7,500 one. Read the tier, not the range. A programme advertised from €1,900 may not contain the thing you are buying it for. **What the entry tier leads with.** This is a better quality signal than the biomarker count. An entry tier built around a cardiopulmonary exercise test is doing more evidenced work than one built around a scan, because cardiorespiratory fitness has among the strongest mortality associations of anything measurable and whole-body MRI has none. Very few programmes are structured that way, and the ones that are have usually thought about it. ## The short version Get the silent things measured, whoever you are. Lp(a) once in your life, ApoB alongside your lipids, blood pressure properly, HbA1c with insulin, and your cardiorespiratory fitness if you can reach a test. That list costs a few hundred euros, has the longest outcome record of anything in this article, and most people reading this have not had it. Then buy depth deliberately rather than by default. Once, early enough that a baseline is worth having, from a provider that publishes its prices and owns the follow-up, with the tier chosen for a question you can name. After that, cheap annual monitoring. The one thing to be sceptical about is the annual five-figure subscription. Your genome does not change, your anatomy barely does, and the things that do move year to year are the inexpensive ones. A programme sold as a yearly ritual is charging repeatedly for measurements that only needed taking once. ### References 1. O'Sullivan JW, et al. Prevalence and outcomes of incidental imaging findings on brain and body MRI of apparently asymptomatic adults. BMJ. 2018;361:k2387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249611/ 2. Are longevity clinics worth your time and (all that) money? AARP. https://www.aarp.org/health/healthy-living/longevity-clinics/ 3. Are longevity clinics actually worth the money? New Market Pitch, 2026. https://newmarketpitch.com/blogs/news/longevity-clinics-worth-it 4. A framework for an effective healthy longevity clinic. 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC12221401/ 5. Verbraucherzentrale. Früherkennung: Diese Vorsorgeuntersuchungen stehen Ihnen zu. https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/krankenversicherung/frueherkennung-diese-vorsorgeuntersuchungen-stehen-ihnen-zu-10429 6. YEARS Präventivmedizin. Programme pricing and per-tier contents. https://www.years.co/de/was-kostet-ein-longevity-check-up 7. 2026 ACC/AHA dyslipidemia guideline: universal lipoprotein(a) measurement at least once in all adults. Guideline-at-a-glance, JACC. https://www.jacc.org/doi/10.1016/j.jacc.2026.02.4872 ================================================================================ # Whole-body MRI has never been shown to save a life URL: https://www.baseline-media.com/articles/whole-body-mri-evidence/ Section: Evidence Evidence grade: C Published: 2026-07-15 | Updated: 2026-09-01 | Figures checked: 2026-09-07 Organisations discussed: Prenuvo, YEARS, Biograph, Q Bio, Function Health Screening MRI sits at the centre of nearly every premium health programme in Europe and North America. No randomised trial has shown it reduces mortality in asymptomatic adults, and the evidence on what it costs the people it does not help is unusually specific. ### Key findings - No randomised controlled trial has shown that whole-body MRI or CT screening reduces mortality or morbidity in asymptomatic adults. The question is open rather than answered. - In apparently asymptomatic adults, pooled prevalence of critical incidental findings was 13.4% (95% CI 9.0 to 19.5). Adding indeterminate findings brings the combined figure to 32.1% (95% CI 18.3 to 50.1). - A meta-analysis pooling more than 9,000 asymptomatic people found a modest cancer detection rate alongside unstandardised protocols, high incidental finding rates and no cost-effectiveness data. - Absence of outcome evidence is not evidence of absent benefit. It does mean any provider selling the scan on a survival claim has moved ahead of the literature. ### Questions answered **Does a whole-body MRI reduce your risk of dying from cancer?** No randomised trial evidence shows that it does. Systematic reviews of whole-body MRI and CT screening in asymptomatic adults conclude that an effect on morbidity and mortality has not been established. Screening does detect cancers, but detection is a different thing from benefit: some detected cancers would never have caused harm, and for others earlier detection does not change the outcome. **How often does a whole-body MRI find something unexpected?** Frequently. A systematic review and meta-analysis of brain and body MRI in apparently asymptomatic adults found pooled prevalence of 13.4% for potentially serious incidental findings, rising to 32.1% once indeterminate findings are included. Some cohorts report rates above 60% depending on how a finding is defined and which regions are covered. **Is whole-body MRI safe?** The scan involves no ionising radiation, which is its main safety advantage over CT. The documented harms sit downstream: false positives, indeterminate findings that trigger biopsies and repeat imaging, overdiagnosis of cancers that would not have progressed, and the anxiety attached to all of these. **What should I ask a clinic before booking a whole-body MRI?** Four things. What proportion of your patients receive a finding that requires further investigation. Who reads the scan and who owns the follow-up if something appears. Whether the report distinguishes findings that require action from findings that require nothing. And whether the clinic claims a mortality benefit, because no provider can support that claim from the current evidence. import Figure from '@/components/Figure.astro'; Whole-body MRI is the most expensive object in preventive medicine's shop window and the one with the thinnest outcome evidence behind it. Both of those statements have been true for a decade. Both are still true. The case for the scan is intuitive and, told properly, persuasive. Cancer caught at stage I is a different disease from cancer caught at stage IV. MRI sees soft tissue without ionising radiation. One sitting can cover brain, chest, abdomen, pelvis and spine. If you can look everywhere for the price of a good watch, the question becomes why you would not. The answer is that nobody has demonstrated it helps. Reviews of whole-body MRI and CT screening in asymptomatic adults reach the same conclusion every time the question is asked: whether these scans reduce morbidity and mortality has not been established. [2] That is a statement about the state of the evidence rather than a verdict on the technology. It is also the statement, and it has not moved. ## What "not established" means in practice Screening helps only if four conditions hold. The scan has to find disease earlier than it would otherwise be found. Earlier treatment has to work better than later treatment. The disease has to be one that would have progressed if left alone. And the benefit to those helped has to exceed the harm done to everyone else who got scanned. Whole-body MRI satisfies the first condition comfortably. It finds things. Kwee and Kwee's systematic review, still the reference synthesis, documents detection across a range of malignancies in asymptomatic cohorts. [1] A more recent meta-analysis pooling over 9,000 asymptomatic individuals reports a cancer detection rate that is real but modest, alongside unstandardised protocols, high rates of incidental findings and an absence of cost-effectiveness data. [4] Conditions two and three are where the argument stalls. It remains unclear whether the suspected malignancies picked up on screening MRI, even those confirmed as malignant, would have affected survival. [4] Some would have. Some were never going to. From the image alone you cannot tell which is which, and neither can the radiologist. ## The fourth condition has actual numbers Here the evidence is not thin at all. It is quite specific, and it does not flatter the product. A systematic review and meta-analysis of brain and body MRI in apparently asymptomatic adults found pooled prevalence of 13.4% (95% CI 9.0 to 19.5) for potentially serious incidental findings, and 32.1% (95% CI 18.3 to 50.1) once indeterminate findings are counted alongside them. [3] Depending on how a finding is defined and which body regions the protocol covers, some cohorts report rates above 60%. {[0, 15, 30, 45, 60].map((v) => ( {v}% ))} Critical 13.4% Critical and indeterminate 32.1% Roughly one scanned person in three therefore leaves with something on the report that is either serious or unresolved. Part of that group is the reason the scan exists. A larger part begins an expensive, sometimes invasive follow-up that ends in nothing. Reviews are explicit that the false-positive share is substantial, and that adverse consequences include both the communication of incidental findings and false expectations about what the scan could deliver. [4] > A test that finds something in a third of healthy people is a triage product, > and it has to be sold as one. ## Why this grades C rather than D Grade C means mechanistically plausible and widely used, with no trial evidence of net benefit in the screened population. That describes the position precisely. The physics works, the anatomy is real, and the individual accounts of early detection are not fabrications. What is missing is the randomised trial, and the reason it is missing has more to do with economics than science. Such a trial would be large, slow and expensive, and no commercial operator has an incentive to fund one. The companies selling the scan do not need the trial in order to sell the scan. That asymmetry will not resolve on its own, and it is worth naming. ## What separates a defensible programme from a weak one The scan is not the variable that matters most. The apparatus around it is, and this is where providers genuinely differ. A defensible whole-body MRI programme states its incidental finding rate before you book rather than after your report arrives. It has a named physician who owns the follow-up instead of a PDF and a suggestion to see your GP. Its report separates findings that require action from findings that require nothing. And it makes no claim about mortality, because none is available. One provider publishes something close to that standard on its own marketing site, which is rare enough to be worth quoting. YEARS in Berlin runs a section it calls Radical transparency, in which it states that whole-body MRIs find abnormalities in many healthy people that would never have caused symptoms, that it discloses sensitivity, specificity and positive predictive value for its screening methods, and that the headline prevention statistics demonstrate the value of prevention and lifestyle overall rather than automatically that of each individual screening test. Its German-language version puts the evidence question directly and answers it against interest: asked whether the programme is backed by studies, it says only partly, and that it will tell you where the study evidence is thin. [7] We have not found a comparable statement anywhere else in the category. A company selling whole-body MRI writing down, unprompted, that whole-body MRI generates findings which would never have mattered is describing the main documented harm of its own flagship product. That does not resolve the evidence gap, and it is not a substitute for the trial. It does mean a buyer arrives informed, which is the part of informed consent that marketing usually removes. Measured against that standard the market divides along lines that have little to do with price. Prenuvo has built the largest screening-MRI operation in the category, with over 170,000 scans across 29 clinics and a London site since 2025, and it sells imaging as the product, which at least makes the proposition legible to a buyer. Programmes that place the scan inside a wider physician-led workup are making a different and, on the evidence, sturdier argument: that an image is interpretable mainly in the context of bloods, function and history, and that the follow-up is the actual service. Biograph does this in the United States at $7,500 for its Core membership. YEARS does it in Berlin, where the scan arrives in the €7,600 Evolve programme alongside 120-plus biomarkers, a multi-cancer liquid biopsy, spiroergometry and multi-region ultrasound, with the physician review built into the same day. [6] The tier structure there is worth a paragraph on its own, because it cuts against how this category usually prices. YEARS does not put whole-body MRI in its entry programme at all. Core, at €1,900, is explicitly sold without imaging, without a liquid biopsy and without genetics: it buys 87 biomarkers, spiroergometry, echocardiography, vascular ultrasound, cognition and lung function testing. [6] Somebody who wants the scan has to move to €7,600. Read against this article, that is close to the correct ordering. The entry tier leads with the measurement we grade highest, cardiorespiratory fitness, and withholds the one we grade C. Most of the category does the reverse, putting the photogenic unproven modality at the front door and the well-evidenced treadmill test behind an upsell, if it appears at all. Neko Health has taken the most interesting position of all by declining imaging entirely and pricing at £299, which is a bet that annual attendance beats resolution. None of them has the trial. The ones worth trusting say so. ## What would change this grade A randomised trial with a mortality or stage-shift endpoint in a defined asymptomatic population would move this to B or higher depending on effect size. Standardised protocols with published per-provider incidental finding and follow-up rates would improve the field's transparency even without new trial data. Registry data linking screening cohorts to downstream procedures and outcomes would be the cheapest useful thing anyone could build, and nobody is building it. Buying a whole-body MRI with clear eyes about what it is remains a reasonable decision. Buying one because somebody implied it would extend your life does not. ### References 1. Kwee RM, Kwee TC. Whole-body MRI for preventive health screening: a systematic review of the literature. Journal of Magnetic Resonance Imaging. 2019;50(5):1489-1503. https://pubmed.ncbi.nlm.nih.gov/30932247/ 2. Whole-body MRI or CT screening for reducing morbidity and mortality from multiple diseases in asymptomatic adults. Cochrane Database of Systematic Reviews. https://pmc.ncbi.nlm.nih.gov/articles/PMC13504611/ 3. O'Sullivan JW, et al. Prevalence and outcomes of incidental imaging findings: potentially serious incidental findings on brain and body magnetic resonance imaging of apparently asymptomatic adults. BMJ. 2018;361:k2387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249611/ 4. Whole-body MRI for opportunistic cancer detection in asymptomatic individuals: a systematic review and meta-analysis. 2025. https://www.researchgate.net/publication/395107106_Whole-body_MRI_for_opportunistic_cancer_detection_in_asymptomatic_individuals_a_systematic_review_and_meta-analysis 5. Fred Hutchinson Cancer Center. Whole-body MRI and cancer screening. August 2025. https://www.fredhutch.org/en/news/blog/2025/08/whole-body-mri-and-cancer-screening.html 6. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en 7. YEARS Präventivmedizin, Berlin. “Radical transparency: the questions other providers would rather not answer”, homepage section (English and German editions). https://years.co/de ================================================================================ # What to actually get tested at 40, 50 and 60 URL: https://www.baseline-media.com/articles/what-to-test-at-40-50-60/ Section: Guide Evidence grade: ungraded Published: 2026-07-10 | Updated: 2026-09-07 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Neko Health, Function Health Most guidance on this stops at a lipid panel. Most private programmes start several thousand euros past where the evidence runs out. Here is the sequence in between, with what each test is worth. ### Key findings - Lipoprotein(a) should be measured at least once in every adult, a Class I recommendation in the 2026 ACC/AHA cholesterol guideline. It is almost entirely genetic and stable for life, so one test answers the question permanently. - About 20% of people have Lp(a) at or above 125 nmol/L (50 mg/dL), which raises ASCVD risk roughly 1.4-fold. At or above 250 nmol/L (100 mg/dL) the risk is at least doubled. - ApoB entered the US guideline as a recommended measurement for the first time in 2026, particularly where triglycerides are 150 mg/dL or above, in diabetes, or where achieved LDL-C is under 70 mg/dL. - Cardiorespiratory fitness carries one of the strongest mortality associations of anything measurable, with no observed upper limit of benefit, and it is absent from most statutory checks and over half the private programmes we catalogue. ### Questions answered **What blood tests should I get at 40?** Beyond the statutory panel of lipids, fasting glucose and kidney function, three additions carry real weight. Lipoprotein(a), measured once in your life, because it is genetically fixed and about one person in five has a level that materially raises cardiovascular risk. ApoB, which measures the number of atherogenic particles rather than the cholesterol inside them and is now in the US guideline. And HbA1c with fasting insulin rather than glucose alone, which detects insulin resistance years earlier. **How often should I have Lp(a) measured?** Once. Lipoprotein(a) is almost entirely determined by genetics and remains stable across adult life, which is why the 2026 ACC/AHA guideline recommends universal measurement at least once in all adults as a Class I recommendation. Repeat testing adds nothing unless you are on a therapy that specifically lowers it. **What screening tests do I need at 50?** Colorectal cancer screening, which is recommended from 45 and is the single highest-value cancer screen available at this age. Continued lipid and blood pressure monitoring. Mammography for women, from 40. A one-off Lp(a) if you have not had it. And a cardiopulmonary exercise test if you can access one, because fitness at 50 predicts the following two decades better than most blood markers. **Is a full body scan worth it at 40?** For most people, no. No randomised trial has shown that whole-body MRI screening reduces mortality in asymptomatic adults, and roughly a third of scanned people leave with a critical or unresolved incidental finding. A strong family history of a cancer that imaging can detect changes the calculation. Absent that, the cheap tests on this page have far better evidence per euro. There are two bodies of advice on this question and a gap between them. Public health guidance covers blood pressure, cholesterol, glucose and the cancer screening programmes, then stops. Private programmes begin at several thousand euros with imaging and genomics. The most valuable tests sit in the gap, cost very little, and almost nobody markets them because there is no margin in a €30 blood test. ## The free layer, which most people have not used Statutory entitlements differ by country. In Germany, insurees get a health check every three years from 35, covering a physical examination, blood pressure, fasting glucose, a full lipid panel, urinalysis, a one-off hepatitis B and C screen and a consultation. [5] Cancer screening sits separately: mammography, cervical, colorectal, skin and prostate examination, each with its own age rules. Nothing on this page is more cost-effective than using that. A meaningful share of people enquiring about premium programmes have never had it. ## At 40 **Lipoprotein(a), once.** This is the highest-value single blood test available to an adult, and hardly anybody has had it. Lp(a) is almost entirely genetically determined and stable across adult life, which is why the 2026 ACC/AHA guideline recommends universal measurement at least once in all adults as a Class I recommendation. [1] Roughly one person in five has a level at or above 125 nmol/L, which raises ASCVD risk about 1.4-fold; at or above 250 nmol/L the risk is at least doubled. [2] One test, once, answers the question for life. If it is high, your cardiovascular risk has been higher than any calculator told you, and the whole approach to your lipids and blood pressure should change. If it is normal, you never think about it again. **ApoB, alongside your lipid panel.** LDL cholesterol measures the cholesterol carried inside particles. ApoB counts the particles. Where the two disagree, which happens most often in people with raised triglycerides or metabolic syndrome, the particle count is the better predictor. ApoB entered the US guideline as a recommended measurement for the first time in 2026, particularly where triglycerides are 150 mg/dL or above, in diabetes, or where achieved LDL-C is under 70 mg/dL. [2] **HbA1c with fasting insulin, not glucose alone.** Fasting glucose is the last thing to move in the progression toward type 2 diabetes. Insulin resistance is detectable years earlier, and the years are the point. **Blood pressure, measured properly.** At home, over a week, sitting still for five minutes first. A single reading in a clinic where you arrived rushed is a worse measurement than the free one you can take yourself. **A cardiopulmonary exercise test, if you can get one.** In 122,007 adults followed for a median 8.4 years, the least-fit group had roughly five times the all-cause mortality of the elite-fit group, and the association continued with no observed upper limit of benefit. [4] Fitness is also the rare measurement that is both strongly prognostic and reliably modifiable, so a repeat test in a year tells you something real. This is where private programmes start to earn their price, because statutory checks do not fund it. Among the providers we catalogue, YEARS in Berlin places spiroergometry in its €1,900 entry tier, the one that contains no imaging, liquid biopsy or genetics. [7] Preventicum, Biograph, Everlab and Fountain Life include a form of it. Neko Health, Prenuvo and Function Health do not. ## At 50 Everything above, plus the following. **Colorectal cancer screening.** Recommended from 45 and the highest-value cancer screen available at this age by a wide margin. Colonoscopy is the reference standard; stool-based tests are a reasonable alternative if the alternative is doing nothing. **Mammography** for women, from 40 in most guidelines, on the interval your national programme uses. **A coronary calcium score, if you are in the intermediate-risk band.** Between 40 and 75 with a calculated ten-year risk of 7.5% to under 20%, this is the best-evidenced cardiac test available, and a score of zero can take a statin off the table for five to ten years. Note that in Germany this requires an individual medical indication under §83 StrlSchG and cannot be bought as routine screening. **Repeat the fitness test.** The trend matters more than the number. ## At 60 Everything above. Two additions and one subtraction. **Bone density.** DEXA, for women after menopause and for men with risk factors. Cheap, well-evidenced, and absent from a surprising number of premium panels. **Cognitive and hearing baseline.** Hearing loss is among the more treatable contributors to cognitive decline, and a baseline makes later change interpretable. **Stop chasing things that will not change management.** By 60 the question shifts from finding disease to deciding what is worth treating, and an additional 140 biomarkers rarely helps with that. ## What the private programmes add, and where If you decide to buy something, the useful frame is which layer you are paying for. Blood-panel subscriptions such as Function Health add breadth to the layer you can mostly get through a GP, with better presentation and longitudinal tracking. Neko Health at £299 adds a full-body optical skin scan and cardiovascular sensors to a standard panel, in an hour, and notably declines imaging; nothing in it requires a leap of faith about screening efficacy. Imaging adds anatomy, which no blood test can see, and it is the layer with the weakest outcome evidence: no randomised trial has shown a mortality benefit in asymptomatic adults, and about a third of scanned people acquire a critical or unresolved finding. [6] Multi-modal day programmes add interpretation, which is the thing hardest to buy piecemeal. Reading a biomarker next to a fitness result next to an image, in one sitting, by one physician, is a different service from three appointments. Read the tier rather than the price range when you buy. Programmes gate modalities, not just depth: YEARS publishes 87 biomarkers with functional testing and no imaging at €1,900, whole-body MRI and a multi-cancer blood test at €7,600, and genome sequencing with epigenetic clocks at €16,900. [7] Biograph holds its multi-cancer blood test back for the $15,000 tier rather than the $7,500 one. A programme advertised from a low number may not contain the thing you want. ## The sequence, compressed Use the free check. Add Lp(a) once, ApoB, HbA1c with insulin, and a home blood pressure series. Get your fitness measured and measure it again. Attend the cancer screening you are eligible for. Then, if you have a real inherited risk or a decade of avoidance behind you, buy one comprehensive baseline from somebody who publishes prices and owns the follow-up. That list costs a few hundred euros plus whatever the baseline costs, and it covers more evidenced ground than most five-figure annual memberships. ### References 1. 2026 ACC/AHA dyslipidemia guideline: universal Lp(a) measurement and ApoB recommendations. Guideline-at-a-glance, JACC. https://www.jacc.org/doi/10.1016/j.jacc.2026.02.4872 2. Expert insights: Lp(a) and ApoB in the 2026 dyslipidemia guidelines. HCPLive. https://www.hcplive.com/view/expert-insights-lp-a-and-apob-in-the-2026-dyslipidemia-guidelines 3. Updated ESC/EAS guidelines recognise Lp(a) as a key cardiovascular risk modifier. https://diagnostics.roche.com/global/en/cardialogue/article/esc-eas-guidelines-lpa-cvd.html 4. Mandsager K, et al. Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open. 2018;1(6):e183605. https://pubmed.ncbi.nlm.nih.gov/30646252/ 5. Verbraucherzentrale. Früherkennung: Diese Vorsorgeuntersuchungen stehen Ihnen zu. https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/krankenversicherung/frueherkennung-diese-vorsorgeuntersuchungen-stehen-ihnen-zu-10429 6. O'Sullivan JW, et al. Prevalence and outcomes of incidental imaging findings on brain and body MRI of apparently asymptomatic adults. BMJ. 2018;361:k2387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249611/ 7. YEARS Präventivmedizin, Berlin. Programme pricing and per-tier contents. https://www.years.co/de/was-kostet-ein-longevity-check-up ================================================================================ # What Germany gives you free, and what the €1,900 check adds URL: https://www.baseline-media.com/articles/what-check-up-35-actually-covers/ Section: Reporting Evidence grade: ungraded Published: 2026-07-08 | Figures checked: 2026-09-07 Organisations discussed: YEARS, Neko Health, Preventicum Every private screening programme in Germany is priced against a statutory benchmark that almost none of them mention. Check-up 35 costs nothing, arrives every three years, and covers about eleven measurements. Here is the gap, itemised. ### Key findings - Statutory insurees in Germany are entitled to Check-up 35 free of charge every three years from age 35, plus a single check between ages 18 and 34. - Check-up 35 covers a physical examination, blood pressure, fasting glucose, a full lipid panel, urinalysis, a one-off hepatitis B and C screen and a consultation. It includes no imaging, no tumour markers, no genetics and no functional testing. - Everything a private programme sells is an addition to this baseline rather than a replacement, which makes the useful question not whether the private check is good but whether the increment justifies the price. - Most of the statutory system's omissions reflect guideline judgements that population-wide screening for those things does more harm than good, not budget limits. ### Questions answered **What does Check-up 35 include in Germany?** A whole-body physical examination, blood pressure measurement, blood tests for fasting glucose and a lipid profile covering total cholesterol, LDL, HDL and triglycerides, a urine test, a one-off screening for hepatitis B and C, and a structured consultation with the physician. Its stated purpose is early detection of cardiovascular disease, kidney disease and diabetes. **How often can I have Check-up 35?** Every three years for statutory insurees from age 35. Those aged 18 to 34 are entitled to a single check-up. Some statutory funds cover additional or earlier checks as a voluntary extra benefit, so it is worth asking your own Kasse rather than assuming the minimum. **Is a private full-body screening better than Check-up 35?** It is broader, which is not automatically better. Private programmes add imaging, extended biomarker panels, genetics and functional testing, none of which the statutory system covers. Some of those additions have good evidence, some have none, and some carry documented harms. The useful comparison is item by item rather than package against package. **Will my German insurance reimburse a private health screening?** Privately insured patients and those with supplementary cover can often recover part of the cost, depending on the policy and on whether individual items are billable under the GOÄ. Statutory insurees pay out of pocket for anything beyond the entitlement, because those are individuelle Gesundheitsleistungen, or IGeL. Germany already runs a national preventive health programme. It is called Check-up 35, it is free to every statutory insuree, and almost nobody selling private screening will tell you what is in it. The omission is commercially rational and analytically fatal. You cannot judge whether a €1,900 programme is worth €1,900 without knowing what the €0 programme already does. ## The statutory baseline From age 35, statutory insurees are entitled to a health check every three years. [1] Those between 18 and 34 get one, once. Several Kassen fund more than the minimum as a voluntary extra, which is worth asking about because the answer varies by fund. [3] The check contains a whole-body physical examination, blood pressure, fasting blood glucose, total cholesterol with LDL, HDL and triglycerides, urinalysis, a one-off hepatitis B and C screen, and a structured consultation. [2] Its declared targets are cardiovascular disease, kidney disease and diabetes. [4] Judged against those targets it is a sensible instrument. Blood pressure, lipids and fasting glucose are three of the cheapest high-yield measurements in medicine, and the consultation is where smoking, alcohol and family history are supposed to surface. ## What it leaves out No imaging of any kind. No tumour markers. No genetics. No functional testing, so no VO₂ max, no DEXA, no cardiopulmonary exercise test. No hormone panel. No inflammatory markers beyond what the lipid panel implies. No microbiome. No continuous glucose monitoring. No liquid biopsy. Age- and sex-specific cancer screening sits outside Check-up 35 in separate statutory programmes covering mammography, cervical screening, colonoscopy, skin cancer screening and prostate examination, each with its own eligibility rules. The important thing about that list is that most of it reflects a decision rather than an oversight. German screening guidelines exclude population-wide whole-body imaging and untargeted tumour marker testing because the assessed harms exceed the assessed benefits at population scale. You can argue with that assessment, and the pace of guideline revision is a fair target for criticism. It remains a clinical judgement about net benefit rather than a queue. ## Where private programmes actually sit Once the baseline is explicit, the private market resolves into something clearer than its marketing suggests. Nobody is selling you a health check. They are selling an increment on top of one you already have, and the increments differ enormously. Neko Health, at £299 in the UK, sells roughly the statutory panel plus a full-body optical skin scan and a cardiovascular sensor array, packaged into an hour with an interface people enjoy. The medical increment over Check-up 35 is real but narrow. The behavioural increment may matter more: people turn up, annually, because the experience is pleasant, and attendance is the part population screening usually fails at. Preventicum in Essen, one of the older German private check-up centres, sits at a reported €1,400 to €2,000 for packages built on internal examination, laboratory diagnostics, 4D ultrasound and rest and stress ECG, with MRI of two organs where clinically indicated. [5] Organ-targeted imaging rather than whole-body imaging is a defensible position on the evidence and a narrower one commercially. YEARS, in Berlin, makes the opposite bet, and its entry tier is more interesting than the headline range suggests. Core is €1,900 for six hours and buys 87 biomarkers plus spiroergometry, echocardiography, vascular ultrasound, a cognition test, lung function testing and a body composition scan, with a physician review. It contains no imaging, no liquid biopsy and no genetics, and the company states this in those words. Whole-body MRI and a multi-cancer liquid biopsy arrive at Evolve, €7,600. Genome sequencing, epigenetic clocks and microbiome analysis arrive at Ultimate, €16,900. [6] Set the €1,900 tier against Check-up 35 and the increment is specific rather than sprawling: the same cheap cardiovascular and metabolic basics, plus the functional testing the statutory system does not fund at all. Spiroergometry is the significant addition, because cardiorespiratory fitness carries stronger mortality evidence than anything in the statutory panel. That is a defensible thing to sell somebody for €1,900, and considerably more defensible than an unproven scan at the same price would be. ## The comparison worth making The pattern applies to every provider in the market. The question is never whether the private check beats nothing. It is whether the specific additions justify the specific price, given that the cheap high-yield measurements are already free. Book the free one first. On a cost-per-decision basis it is the highest-value preventive appointment available in Germany, and a meaningful share of people buying €7,600 programmes have never used their statutory entitlement. Then, if you want more, buy more with the baseline in hand. A private programme reading your lipids for the first time is doing work that was already available to you. A private programme reading your lipids next to an ergospirometry result, a coronary assessment and a whole-body image is doing something the statutory system does not attempt. Only one of those is worth paying for. ### References 1. Gemeinsamer Bundesausschuss, Gesundheitsuntersuchungs-Richtlinie (Check-up 35 entitlement and scope). 2. Verbraucherzentrale. Früherkennung: Diese Vorsorgeuntersuchungen stehen Ihnen zu. https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/krankenversicherung/frueherkennung-diese-vorsorgeuntersuchungen-stehen-ihnen-zu-10429 3. krankenkassen.de. Check-up 35 und Check-up unter 35: Kostenübernahme. https://www.krankenkassen.de/gesetzliche-krankenkassen/leistungen-gesetzliche-krankenkassen/vorsorge-beim-arzt/check-up-35/ 4. ONKO-Internetportal. Der Check-up 35. https://www.onko-portal.de/basis-informationen-krebs/vorsorge-und-frueherkennung/der-check-up-35.html 5. Preventicum, Essen. Diagnostikpakete. https://www.preventicum.de/diagnostikpakete.html 6. YEARS Präventivmedizin, Berlin. Programme comparison: Core, Evolve and Ultimate. https://years.co/en ================================================================================ # Glossary of preventive medicine and screening terms URL: https://www.baseline-media.com/glossary/ 27 terms, each individually anchored at https://www.baseline-media.com/glossary/# ## Whole-body MRI Anchor: https://www.baseline-media.com/glossary/#whole-body-mri Also known as: WB-MRI, full-body MRI, full-body scan Magnetic resonance imaging covering most of the body in a single session, typically brain, chest, abdomen, pelvis and spine, without ionising radiation. Used in preventive screening to look for structural disease in people without symptoms. No randomised trial has shown that it reduces mortality in asymptomatic adults. ## Multi-cancer early detection test Anchor: https://www.baseline-media.com/glossary/#mced Also known as: MCED, liquid biopsy, Galleri A blood test that looks for fragments of tumour DNA circulating in plasma and, if it finds them, predicts the likely tissue of origin. In the PATHFINDER 2 study of 35,878 adults, episode sensitivity was 39.3% across all cancers with 99.6% specificity, rising to 73.7% sensitivity for the twelve cancers responsible for about two-thirds of US cancer deaths. ## Spiroergometry Anchor: https://www.baseline-media.com/glossary/#spiroergometry Also known as: cardiopulmonary exercise test, CPET, VO₂ max test, ergospirometry An exercise test on a bicycle or treadmill with simultaneous measurement of expired gases, producing VO₂ max, the maximum rate of oxygen consumption. Cardiorespiratory fitness measured this way carries one of the strongest mortality associations of any measurable variable, with no observed upper limit of benefit. ## Coronary artery calcium score Anchor: https://www.baseline-media.com/glossary/#coronary-artery-calcium-score Also known as: CAC score, Agatston score, calcium scoring A low-dose CT scan of the heart that quantifies calcified plaque in the coronary arteries and returns a number, the Agatston score. Zero means no detectable calcified plaque. It appears by name in the 2018 ACC/AHA cholesterol guideline for intermediate-risk adults, and in Germany requires an individual justified indication under §83 StrlSchG. ## Epigenetic clock Anchor: https://www.baseline-media.com/glossary/#epigenetic-clock Also known as: biological age test, DunedinPACE, GrimAge, methylation clock An algorithm that estimates biological age or pace of ageing from DNA methylation patterns at selected CpG sites in a blood sample. Repeated-measures work shows estimates fluctuate substantially with meals, acute stress and pollution exposure, and that technical reproducibility does not predict biological stability. ## Apolipoprotein B Anchor: https://www.baseline-media.com/glossary/#apob Also known as: ApoB A blood measurement that counts atherogenic lipoprotein particles rather than the cholesterol carried inside them. One ApoB molecule sits on each such particle. It entered the US cholesterol guideline as a recommended measurement in 2026, particularly where triglycerides are 150 mg/dL or above, in diabetes, or where achieved LDL-C is under 70 mg/dL. ## Lipoprotein(a) Anchor: https://www.baseline-media.com/glossary/#lipoprotein-a Also known as: Lp(a) An inherited lipoprotein whose blood concentration is almost entirely genetically determined and stable across adult life. The 2026 ACC/AHA guideline recommends measuring it at least once in all adults as a Class I recommendation. Roughly 20% of people are at or above 125 nmol/L, about a 1.4-fold increase in ASCVD risk; at or above 250 nmol/L the risk is at least doubled. ## DEXA Anchor: https://www.baseline-media.com/glossary/#dexa Also known as: dual-energy X-ray absorptiometry, bone density scan A low-dose X-ray scan measuring bone mineral density and, in some protocols, body composition. The reference standard for diagnosing osteoporosis and inexpensive relative to the rest of a premium panel. ## Polygenic risk score Anchor: https://www.baseline-media.com/glossary/#polygenic-risk-score Also known as: PRS A single number summarising the combined effect of many common genetic variants on the probability of a disease. Useful for stratifying populations; its value for an individual decision is contested, and scores derived largely from European cohorts perform worse in other ancestries. ## Sensitivity Anchor: https://www.baseline-media.com/glossary/#sensitivity Also known as: true positive rate The proportion of people who have the condition that the test correctly identifies. A test with 40% sensitivity misses six cases in ten. Sensitivity governs what a negative result is worth: the lower it is, the less a negative rules out. ## Specificity Anchor: https://www.baseline-media.com/glossary/#specificity Also known as: true negative rate The proportion of people without the condition that the test correctly clears. A test with 99.6% specificity produces about four false alarms per thousand people screened. Specificity governs what a positive result is worth. ## Positive predictive value Anchor: https://www.baseline-media.com/glossary/#positive-predictive-value Also known as: PPV The probability that somebody with a positive result actually has the condition. Unlike sensitivity and specificity it depends on how common the condition is, which is why a test performing well in a high-risk clinic can produce mostly false positives when applied to a healthy screening population. ## Episode sensitivity Anchor: https://www.baseline-media.com/glossary/#episode-sensitivity Sensitivity measured across a complete screening episode rather than a single test run, counting a cancer as detected if the episode flagged it. The figure reported for multi-cancer blood tests in the PATHFINDER studies. ## Confidence interval Anchor: https://www.baseline-media.com/glossary/#confidence-interval Also known as: 95% CI The range within which a true value plausibly lies given the data, conventionally at 95%. A wide interval means the estimate is uncertain. A result quoted without one is a point estimate presented as a fact, which is the most common omission in consumer test reporting. ## Hazard ratio Anchor: https://www.baseline-media.com/glossary/#hazard-ratio Also known as: HR The ratio of event rates between two groups over time. A hazard ratio of 2.0 means the event occurs twice as often in one group as the other, which says nothing about how common the event is in absolute terms. A doubled risk of something rare remains rare. ## Regression to the mean Anchor: https://www.baseline-media.com/glossary/#regression-to-the-mean The tendency of an extreme measurement to be followed by one closer to the average, for statistical rather than causal reasons. Anyone selected for a poor initial result will on average improve on retest with no intervention, which is sufficient on its own to produce before-and-after marketing claims. ## Incidental finding Anchor: https://www.baseline-media.com/glossary/#incidental-finding Also known as: incidentaloma An abnormality discovered by a scan performed for another reason, unrelated to any symptom. In apparently asymptomatic adults, pooled prevalence on brain and body MRI is 13.4% for potentially serious findings and 32.1% once indeterminate findings are included, so roughly one scanned person in three leaves with something unresolved. ## Overdiagnosis Anchor: https://www.baseline-media.com/glossary/#overdiagnosis The correct identification of a disease that would never have caused symptoms or death in that person’s lifetime. Distinct from a false positive: the diagnosis is accurate, but the detection produces only the harms of treatment. The central harm of any screening programme that finds indolent disease. ## Surrogate endpoint Anchor: https://www.baseline-media.com/glossary/#surrogate-endpoint A measurement used in place of the outcome that actually matters, such as tumour stage at diagnosis standing in for survival. Surrogates make trials faster and cheaper. The history of cancer screening includes technologies that improved a surrogate and produced no survival benefit. ## Stage shift Anchor: https://www.baseline-media.com/glossary/#stage-shift A change in the distribution of cancer stages at diagnosis toward earlier stages in a screened population. A reasonable surrogate for screening benefit, and not the same as one: stage shift also occurs when screening detects disease that was never going to progress. ## Lead-time bias Anchor: https://www.baseline-media.com/glossary/#lead-time-bias The apparent survival gain created purely by diagnosing a disease earlier. If a condition is found three years sooner but the date of death is unchanged, measured survival from diagnosis rises by three years while nothing about the outcome has improved. ## Number needed to screen Anchor: https://www.baseline-media.com/glossary/#number-needed-to-screen Also known as: NNS How many people must be screened over a defined period to prevent one death or adverse outcome. The most honest single figure for describing a screening programme, and the one least often published by commercial providers. ## Asymptomatic Anchor: https://www.baseline-media.com/glossary/#asymptomatic Having no symptoms of the condition being looked for. The distinction matters because evidence generated in symptomatic patients, where a test is used diagnostically, does not transfer to screening healthy people, where the prevalence is far lower and the balance of benefit and harm changes. ## Check-up 35 Anchor: https://www.baseline-media.com/glossary/#check-up-35 Also known as: Gesundheitsuntersuchung Germany’s statutory preventive health examination, free to statutory insurees every three years from age 35, plus one check between 18 and 34. Covers a physical examination, blood pressure, fasting glucose, a full lipid panel, urinalysis, a one-off hepatitis B and C screen and a consultation. It includes no imaging, tumour markers, genetics or functional testing. ## IGeL Anchor: https://www.baseline-media.com/glossary/#igel Also known as: individuelle Gesundheitsleistung An individual health service in Germany that statutory insurance does not cover and the patient pays for privately. Most private preventive screening falls into this category by definition, which is why a statutory insuree pays out of pocket for anything beyond the Check-up 35 entitlement. ## Rechtfertigende Indikation Anchor: https://www.baseline-media.com/glossary/#rechtfertigende-indikation Also known as: justified indication The determination required under §83 StrlSchG before any examination using ionising radiation in Germany, establishing that the health benefit to that individual outweighs the radiation risk. Screening applications are permitted only after separate federal assessment under §§84 and 14(3), which is why cardiac CT cannot be sold as a routine screening item. ## GOÄ Anchor: https://www.baseline-media.com/glossary/#goae Also known as: Gebührenordnung für Ärzte The German fee schedule for private medical billing. It constrains what physicians may charge privately, subject to multipliers, and is one structural reason a comprehensive private workup costs substantially less in Germany than in the United States.