My top 5 ASX 200 shares to buy and hold

When I am looking for S&P/ASX 200 index (ASX: XJO) shares to buy and hold for many years, I want ones with strong positions today and plenty of room to become larger over time.

With that in mind, these are my top five ASX shares for the long term.

Woman using a pen on a digital stock market chart in an office. — Image source: Getty Images

Pro Medicus Ltd (ASX: PME)

Pro Medicus has built a strong position in medical imaging through its Visage software platform.

Its technology helps hospitals and radiologists view and manage enormous medical imaging files quickly, which becomes increasingly important as healthcare systems generate more data.

I like the opportunity in the US. Pro Medicus has already won major hospital networks, but there is still a large market left to capture.

The company also has room to expand beyond radiology into areas such as cardiology and enterprise imaging. Artificial intelligence could add another capability to the platform as hospitals look for better ways to analyse images and manage growing workloads.

Overall, I think Pro Medicus could be a much larger healthcare technology business a decade from now.

Sigma Healthcare Ltd (ASX: SIG)

Sigma Healthcare gives investors exposure to the Chemist Warehouse business following the combination of the two companies.

Chemist Warehouse has built one of Australia’s strongest retail brands, with a model based on large stores, competitive pricing, and enormous customer traffic.

What interests me most is the opportunity to take that model overseas.

The business already has a growing presence in New Zealand and has begun exploring the UK market. If Chemist Warehouse can successfully replicate even part of its Australian success internationally, I think there could be a long runway ahead.

This ASX 200 share has developed a platform that millions of families use to stay connected and keep track of the people and things that matter to them.

The core family location-sharing service gives the company a large audience, and I think the bigger opportunity is building more products around that relationship.

Life360 has been expanding into areas such as driving safety, identity protection, pets, and ageing family members.

Its international opportunity also interests me. The service can be used across a huge number of countries, giving Life360 room to grow well beyond its established US audience.

If it can keep adding users and give those users more reasons to pay for its services, I think Life360 has the ingredients for long-term growth.

Commonwealth Bank of Australia (ASX: CBA)

Commonwealth Bank is one of Australia’s strongest banking franchises.

Its enormous customer base gives it relationships across home lending, everyday banking, business banking, credit cards, and wealth-related services.

I also like the investment the bank has made in technology. Its digital banking capabilities can make the customer experience easier while allowing Commonwealth Bank to serve millions of people efficiently.

Australia’s population and economy should continue growing over the long term, creating opportunities for more deposits, loans, payments, and business banking activity.

CBA may already be enormous, but I think its scale and brand give it a strong platform to keep compounding over time.

BHP remains one of my favourite ways to gain exposure to the resources needed by the global economy.

The company owns large, long-life assets across commodities including iron ore and copper, giving it exposure to infrastructure spending, industrial activity, and electrification.

Copper is particularly interesting to me over the longer term. Expanding electricity grids, renewable energy, data centres, and electric vehicles could require enormous amounts of the metal.

BHP also has the financial strength and operating experience to invest in major projects that smaller miners may struggle to develop.

I think that combination of scale, high-quality assets, and exposure to long-term commodity demand makes BHP a share I would be comfortable holding through multiple market cycles.