Preventive Medicine/Screening: (USPSTF)¶
Whitney George
- Refer to US Preventative Services Task Force for complete list of Grade A & B recommendations: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-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 |