Screening Recommendations for Chronic Disease
Quick blog today to review the screening recommendations from the US Preventive Services Task Force. I often get asked how often someone should get their Pap smear or blood sugar checked. I don’t agree with all of their recommendations, but I appreciate that the U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine.
Overall, the Task Force’s goal is to improve the health of Americans by making evidence-based recommendations about clinical preventive services.
Here are several of their recommendations for women by date and quality of evidence. This is a partial list that I made that were relevant to me and most women. Go to their site for the full list of recommendations by date, including more recommendations for childhood and pregnancy.
|June 2016*||Colorectal cancer screening||The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years.||A|
|April 2016*||Aspirin preventive medication: adults aged 50 to 59 years with a ≥10% 10-year cardiovascular risk||The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease and colorectal cancer in adults aged 50 to 59 years who have a 10% or greater 10-year cardiovascular risk, 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||B|
|February 2016*||Depression screening: adolescents||The USPSTF recommends screening for major depressive disorder (MDD) in adolescents aged 12 to 18 years. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.||B|
|January 2016*||Depression screening: adults||The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.||B|
|October 2015*||Diabetes screening||The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to promote a healthful diet and physical activity.||B|
|October 2015*||High blood pressure in adults: screening||The USPSTF recommends screening for high blood pressure in adults aged 18 years or older. The USPSTF recommends obtaining measurements outside of the clinical setting for diagnostic confirmation before starting treatment.||A|
|August 2014*||Healthy diet and physical activity counseling to prevent cardiovascular disease: adults with cardiovascular risk factors||The USPSTF recommends offering or referring adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.||B|
|January 2014||Gestational diabetes mellitus screening||The USPSTF recommends screening for gestational diabetes mellitus in asymptomatic pregnant women after 24 weeks of gestation.||B|
|March 2012*||Cervical cancer screening||The USPSTF recommends screening for cervical cancer in women ages 21 to 65 years with cytology (Pap smear) every 3 years or, for women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.||A|
|January 2012*||Osteoporosis screening: women||The USPSTF recommends screening for osteoporosis in women age 65 years and older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors.||B|
|September 2002†||Breast cancer screening||The USPSTF recommends screening mammography for women, with or without clinical breast examination, every 1 to 2 years for women age 40 years and older.||B|
†The Department of Health and Human Services, under the standards set out in revised Section 2713(a)(5) of the Public Health Service Act and Section 9(h)(v)(229) of the 2015 Consolidated Appropriations Act, utilizes the 2002 recommendation on breast cancer screening of the U.S. Preventive Services Task Force. To see the USPSTF 2016 recommendation on breast cancer screening, go to http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening1.
*Previous recommendation was an “A” or “B.”
Here are the what the grades mean, again from their website.
|Grade||Definition||Suggestions for Practice|
|A||The USPSTF recommends the service.
There is high certainty that the net benefit is substantial.
|Offer or provide this service.|
|B||The USPSTF recommends the service.
There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.
|Offer or provide this service.|