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/recommendationtopics/ 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
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
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
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 communitydwelling 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 lowdose 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
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