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Preventive Medicine/Screening: (USPSTF)

Whitney George

  • Refer to US Preventative Services Task Force for complete list of Grade A & B recommendations:
  • Grade A recommendation definition: There is high certainty that the net benefit is substantial.
  • Grade B recommendation definition: There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.
  • Recommend downloading the “CDC Vaccine Schedules” App on your phone to easily filter by medical condition or look at contraindications
Preventative Measures for WOMEN
Preventative Measure Guidelines Grade
Cervical cancer Ages 21-29: q 3 yrs with cervical cytology alone.
Ages 30-65: q 3 yrs with cervical cytology alone, every 5 years w/ high-risk human papillomavirus (hrHPV) testing alone
or q 5 yrs with hrHPV testing in
combination with cytology (co-testing)
***ACS 2020 guideline change –Age 25-65: preferred HPV test alone q 5 years (or HPV/Pap co-test every 5 years or a Pap every 3 years)***
Grade A
Breast cancer Women 50-74: q2 years
ACS recommends beginning at age 45-54 annually, 55+ q2 hrs in women with average risk.
If family or personal history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated BRCA1/2 gene mutations - should assess risk and refer to genetic counseling.
Grade B
Folic acid All women who are planning or capable of pregnancy should take daily folic acid supplement (0.4 – 0.8 mg daily) Grade A
Chlamydia Gonorrhea All sexually active women < 24, older women with increased risk Grade B
Osteoporosis (DEXA) Women >65, postmenopausal women <65 with increased osteoporosis risk (can use FRAX tool) Grade B
Preventative Measures for MEN
Preventive Measure Guidelines Grade
Abdominal aortic aneurysm (AAA) screening Men Ages 65-75 who ever smoked (at least 100 cigarettes total): one-time screening by ultrasonography Grade B
Preventative Measures for ALL pts
Preventative Measure Guidelines Grade
Cholesterol screening Men >35 or 20-35 with CV risk
Women >45 or 20-45 with CV risk
UpToDate: Grade 2C
Colorectal cancer All adults age 45-75
FOBT annually
FIT annually
FIT-DNA (Cologuard) q1-3 years
Colonoscopy q 10 years
Flexible sigmoidoscopy q 5 years

Screen earlier if: family hx of CRC or adenomatous polyps at age < 60, hx of IBD, a confirmed or suspected hereditary CRC syndrome, or a hx abdominal/pelvic radiation
Grade A for ages 50-75; Grade B for ages 45-49
Depression Screen for depression in general adult populations. If screening, must ensure systems are in place for accurate diagnosis, effective treatment, and appropriate follow up Grade B
Diabetes screening Adults age 35-70 who are overweight or obese Grade B
Falls Provide exercise interventions to prevent falls in community-dwelling adults >65 years old who are at increased risk for falls Grade B
Cardiovascular health Blood pressure screening annually adults >18 Grade A
Aspirin 81 mg in age 50-59 with ASCVD risk >10% in 10 years, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years. Grade B
Statin: See section on Lipids Grade B
Hepatitis C Adults aged 18 to 79 years (one time screening) Grade B
HIV All adolescents and adults 15-65 (one time screening) Grade A
Lung cancer Low-dose CT adults 50-80 w/20 pack year smoking history and currently smoke or quit within the past 15 years

Should discuss risk vs benefits, particularly in pts with serious co-morbidities who may not tolerate/desire surgery or aggressive treatment.
Grade B
Obesity BMI annually in all adults Grade A