Preventative Medicine

Preventive Medicine/Screening: (USPSTF) – Toaa Abuelenen, Emily Camp

  • Recommend downloading the “CDC Vaccine Schedules” App on your phone to more easily filter by medical condition or look at contraindications
  • https://www.cdc.gov/vaccines/schedules/index.html

 

Preventative Measures for ALL patients

Cholesterol

Men >35 or 20-35 with CV risk

Women >45 or 20-45 with CV risk

Grade A

UpToDate: Grade 2C

Colorectal cancer

All adults age 50-75

- FOBT annually

- FIT annually

 - FIT-DNA (Cologuard)

q  1 or 3 years

- Colonoscopy q 10 years

- Flexible sigmoidoscopy q 5 years

 

Screen earlier if: family hx of CRC or adenomatous polyps at age < 60, a personal hx of IBD, a confirmed or suspected hereditary CRC syndrome, or a hx of abdominal or pelvic radiation

Grade A

Diabetes screening

Adults age 40-70 who are overweight or obese

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 55-80 w/30 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

Depression

All adults including pregnant and post-partum women

Grade B

 

 

Preventative Measures for WOMEN:

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 40, Yearly

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

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

 

Preventive Measures for MEN

Abdominal aortic aneurysm (AAA) screening

Men Ages 65-75 who ever smoked (at least 100 cigarettes total): one-time screening by ultrasonography

Grade B