AAFP Screening Guidelines Flashcards
1
Q
Illicit Drug Use
A
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening adolescents, adults, and pregnant women for illicit drug use.
2
Q
Second Hand Smoke
A
The AAFP strongly recommends to counsel smoking parents with children in the house regarding the harmful effects of smoking and children’s health.
3
Q
Vitamin D Deficiency
A
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for Vitamin D Deficiency.
4
Q
Gonococcal Infection in Neonates, Ocular Topical Medication
A
The AAFP strongly recommends prophylactic ocular topical medication for all newborns against gonococcal ophthalmia neonatorum.
5
Q
Sickle Cell Disease, Newborns
A
The AAFP recommends screening for sickle cell disease in all newborns.
6
Q
Iron deficiency Anemia, Children
A
The AAFP concludes that the evidence is insufficient to recommend for or against routine screening for iron deficiency anemia in asymptomatic children aged 6 to 12 months.
7
Q
Lead Poisoning, Children
A
The AAFP concludes that evidence is insufficient to recommend for or against routine screening for elevated blood lead levels in asymptomatic children aged 1 to 5 years who are at increased risk.
8
Q
Ovarian Cancer/BRCA Mutation Testing
A
The AAFP recommends that women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for BRCA testing.
The AAFP recommends against routine referral for genetic counseling or routine BRCA testing for women whose family history is not associated with increased risk for deleterious mutations in BRCA1/2.
9
Q
Skin Cancer, Screening
A
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin exam by a PCP or patient skin self-exam for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.
10
Q
Rh (D) Incompatibility, Pregnant Women
A
The AAFP strongly recommends Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care.
The AAFP recommends repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24-28 weeks’ gestation. (
11
Q
Diabetes, Gestational
A
The AAFP recommends screening for gestational diabetes mellitus in asymptomatic pregnant women after 24 weeks of gestation.
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for GDM in asymptomatic pregnant women before 24 weeks of gestation.
12
Q
Genital Herpes Simplex Virus Infection, NonPregnant Adolescents and Adults
A
The AAFP recommends against routine serological screening for HSV in asymptomatic adolescents and adults.
13
Q
Genital Herpes Simplex Virus Infection, Pregnant Women
A
The AAFP recommends against routine serological screening for HSV in asymptomatic pregnant women at any time during pregnancy to prevent neonatal HSV infection.
14
Q
Depression, Adults
A
The AAFP recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up. [“Staff-assisted depression care supports” refers to clinical staff that assist the PCP by providing some direct depression care and/or coordination, case management, or mental health treatment.]
The AAFP recommends against routinely screening adults for depression when staff-assisted depression care supports are not in place. There may be considerations that support screening for depression in an individual patient.
15
Q
Lipid Disorders, Adults
A
The AAFP recommends screening men aged 35 and older for lipid disorders.
The AAFP recommends screening men 20-35 and women 20 and older for lipid disorders if they are at increased risk for CAD.
The AAFP makes no recommendation for or against routine screening for lipid disorders in men aged 20 to 35, or in women aged 20 and older who are not at increased risk for CAD.
16
Q
Speech and Language Delay in Preschool Children
A
The AAFP concludes that the evidence is insufficient to recommend for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children up to 5 years of age.
17
Q
Breastfeeding, Structured Education and Counseling
A
The AAFP recommends interventions during pregnancy and after birth to promote and support breastfeeding.
18
Q
Thyroid Dysfunction Screening, Adults
A
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for thyroid dysfunction in nonpregnant, asymptomatic adults.
19
Q
Neural tube defects, Prevention, Folic Acid Supplementation, Women
A
The AAFP recommends that all women planning or capable of pregnancy take a daily supplement containing 0.43 to 0.8 mg (400 to 800 µg) of folic acid.
20
Q
Chronic Obstructive Pulmonary Disease, Adults
A
The AAFP recommends against screening asymptomatic adults for COPD using spirometry.
21
Q
Falls Prevention in Older Adults
A
The AAFP recommends exercise/PT and vitamin D supplementation in community-dwelling adults aged 65 years or older who are at increased risk for falls
The AAFP does not recommend automatically performing an in-depth multifactorial risk assessment in conjunction with comprehensive management of identified risks to prevent falls in community-dwelling adults aged 65 years or older because the likelihood of benefit is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of the circumstances of prior falls, co-morbid medical conditions, and patient values.
22
Q
Immunizations, Adults
A
The AAFP recommends immunizing all adults using the AAFP recommendations unless contraindicated
23
Q
Illicit or Nonmedical Drug Use, in Children and Adolescents
A
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral interventions to prevent or reduce illicit drug or nonmedical pharmaceutical use in children and adolescents. This recommendation applies to children and adolescents who have not already been diagnosed with a substance use disorder.
24
Q
Tobacco Use, Adults
A
The AAFP recommends that clinicians screen all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco products.
25
Abdominal Aortic Aneurysm, Men
The AAFP recommends one-time screening for AAA by ultrasonography in men ages 65 to 75 years who have ever smoked.
The AAFP recommends that clinicians selectively offer screening for AAA in men ages 65 to 75 years who have never smoked rather than routinely screening all men in this group
26
Breast Cancer, Digital Mammography or MRI
The AAFP concludes that current evidence is **insufficient** to assess benefits and harms of either digital mammography or MRI **instead of film screen mammography** as screening modalities for breast cancer.
27
Hearing Loss Sensorineural (SNHL)
The AAFP **recommends** screening for hearing loss in **all** newborn infants.
28
Sexually Transmitted Infections
The AAFP **recommends** intensive **behavioral counseling** for **all sexually active adolescents** and for **adults at increased risk** for STIs
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of **behavioral counseling** to prevent STIs in **non-sexually active adolescents** and in **adults not at increased risk** for STIs.
29
Venous Thromboembolism, Genomic Testing
The AAFP recommends **against** routine testing for Factor V Leiden and/or prothrombin 2012G (PT) in asymptomatic adult family members of patients with venous thromboembolism, for the purpose of considering primary prophylactic anticoagulation. This recommendation does not extend to patients with other risk factors for thrombosis such as contraception use.
30
Alcohol Misuse, Adolescents
The AAFP recognizes the avoidance of alcohol products by adolescents aged 12 to 17 years is desirable. The effectiveness of the physician's advice and counseling in this area is **uncertain.**
31
Idiopathic Scoliosis in Adolescents
The AAFP recommends **against** the routine screening of asymptomatic adolescents for idiopathic scoliosis.
32
Motor Vehicle Occupant Restraints
The AAFP recognizes the use of motor vehicle occupant restraints is desirable to prevent motor vehicle occupant injuries. The effectiveness of physician’s **advice and counseling** in this is area is **uncertain**.
33
Breast Cancer, Mammography
| (for women with average risk)
The AAFP **recommends** **biennial** (every two years) screening mammography for women between ages 50-74.
The AAFP concludes that the current evidence is **insufficient** to assess the benefits and harms of screening mammography in women aged **75 years and older**.
34
Breast Cancer, Self BSE
The AAFP recommends **against** clinicians teaching women Breast Self-Examination (BSE)
35
Ovarian cancer
The AAFP recommends **against** screening for ovarian cancer in women.
36
Cervical Cancer
The AAFP **recommends** screening for cervical cancer in women **21-65** with **cytology** **every 3 years** or, for women **30-60** who want to lengthen the screening interval, screening with **cytology and HPV** testing **every 5 years.**
The AAFP recommends **against** screening for cervical cancer in women
The AAFP recommends **against** screening for cervical cancer with **HPV** testing, alone or in combination with cytology, in women
The AAFP recommends **against** screening for cervical cancer in women **\>65** who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
The AAFP recommends **against** screening for cervical cancer in women who have had a **hysterectomy with removal of the cervix** and who **do not have a history** CIN grade 2 or 3 or cervical cancer.
37
Bacteriuria, Asymptomatic, Pregnant Women
The AAFP **recommends** screening for asymptomatic bacteriuria with urine culture for pregnant women at **12 to 16 weeks’** gestation or at the first prenatal visit, if later.
38
Colorectal Cancer, Adults
The AAFP **recommends** screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonscopy, in adults, beginning at age **50 years** and continuing **until age 75**. The risk and benefits of these screening methods vary.
The AAFP recommends **against** routine screening for colorectal cancer in adults **76-85**. There may be considerations that support colorectal caner screening in an individual patient.
The AAFP recommends **against** screening for colorectal cancer in adults **\>85.**
The AAFP concludes that the evidence is **insufficient** to assess the benefits and harms of **computed tomographic colongraphy and fecal DNA testing** as screening modalities for colorectal cancer.
39
Alcohol Misuse, Adults
The AAFP **recommends** that clinicians screen adults aged **18 years or older** for alcohol misuse and provide persons engaged in **risky or hazardous drinking** with **brief behavioral counseling** interventions to reduce alcohol misuse.
40
Tobacco Use, Counseling, Children and Adolescents
The AAFP **recommends** that primary care clinicians **provide interventions**, including education or brief counseling, to **prevent initiation** of tobacco use among school-aged children and adolescents.
41
Maltreatment, Children
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment. This recommendation applies to children who **do not have signs or symptoms** of maltreatment.
42
Oral Cancer, Adults
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for oral cancer in asymptomatic adults.
43
Chlamydia, Men
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men.
44
Vitamin D and Calcium Supplementation, Prevention of Fractures in Premenopausal Women or Men
The AAFP concludes that the current evidence is **insufficient** to assess the balance of the benefits and harms of combined vitamin D and calcium supplementation for the primary prevention of fractures in **premenopausal women or in men**.
45
Osteoporosis, Women
The AAFP **recommends** screening for osteoporosis in **women aged 65 years or 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.
[A **65-year-old white woman** with no other risk factors has a **9.3% 10-year risk** for any osteoporotic fracture]
46
Hyperbilirubinemia, Infants
The AAFP concludes that the evidence is **insufficient** to recommend screening infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy
47
Syphilis, Pregnant Women
The AAFP **recommends** that clinicians screen **all** pregnant women for syphilis infection
48
Colorectal Cancer, Chemo Prevention
The AAFP recommends **against** the routine use of ASA and NSAIDs to prevent colorectal cancer in individuals at **average risk** for colorectal cancer.
49
Insulin Dependent Diabetes Mellitus
The AAFP recommends **against** the use of immune marker screening for insulin dependent diabetes mellitus in asymptomatic persons
50
Visual Impairment, Children
The AAFP **recommends** vision screening for **all** children **at least once** between the **ages of 3 and 5** years to detect the presence of amblyopia or its risk factors.
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of vision screening for children **of age.**
51
Bacteriuria, Asymptomatic, Men and NonPregnant Women
The AAFP **recommends against** screening for asymptomatic bacteriuria in men and nonpregnant women.
52
Obesity, Children and adolescents
The AAFP **recommends** that clinicians screen children aged **6 years and older** for obesity and offer them or refer them to comprehensive, intensive **behavioral interventions** to promote improvement in weight status.
53
Breast Cancer, Prevention Medication
| (for women at increased risk)
The AAFP recommends that clinicians engage in shared, informed decision making with women who are at **increased risk** for breast cancer about medications to reduce their risk. For women who are at increased risk for breast cancer and at low risk for adverse medication effects, clinicians **should** offer to prescribe risk reducing medications such as **tamoxifen or raloxifene.**
54
Pancreatic Cancer, Adult
The AAFP recommends **against** routine screening for pancreatic cancer in asymptomatic adults using abdominal palpation, ultrasonography, or serologic markers. (
55
Breast Cancer, Clinical Examination (CBE)
The AAFP concludes that the current evidence is **insufficient** to assess the benefits and harms of CBE for women aged **40 years and older.**
56
Thyroid Cancer
The AAFP recommends **against** the use of ultrasound screening for thyroid cancer in asymptomatic persons.
57
Peripheral Arterial Disease
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for peripheral artery disease (PAD) and cardiovascular disease (CVD) risk assessment with the ankle– brachial index (ABI) in adults
58
HIV Infection, Pregnant Women
The AAFP **recommends** that clinicians screen **all** pregnant women for HIV, including those who present in labor whose HIV status is unknown.
59
Skin Cancer, Behavioral Counseling
The AAFP **recommends** counseling children, adolescents, and young adults ages **10 to 24** years who have **fair skin** about minimizing their exposure to ultraviolet radiation to reduce risk of skin cancer.
60
Visual Difficulties, Adults
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefit and harms of screening for visual acuity for the improvement of outcomes in older adults.
61
Dysplasia (Developmental) of the Hip in Infants
The AAFP concludes that the evidence is **insufficient** to recommend routine screening for developmental dysplasia of the hip in infants as a means to prevent adverse outcomes.
62
Behavior Counseling, Healthful Diet and Physical Activity for Cardiovascular Disease
The AAFP **recommends** offering or referring adults who are **overweight or obese** and have additional **CVD risk factors** to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD.
63
Bladder Cancer, Adults
The AAFP concludes that the evidence is **insufficient** to assess the balance of benefits and harms of screening for bladder cancer in **asymptomatic** adults.
64
Glaucoma, Adults
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for primary open-angle glaucoma in adults.
65
Syphilis, non-pregnant adults
The AAFP **strongly recommends** that clinicians screen persons at **increased risk** for syphilis infection
The AAFP recommends **against** routine screening of asymptomatic persons who are **not at increased risk** for syphilis infection
66
Hearing, Screening Loss in Older Adults
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for hearing loss in asymptomatic adults **50 years and older.**
Clinical Considerations: This recommendation applies to adults age 50 years and older who show **no signs or symptoms** of hearing loss.
67
Hypertension, Adults
The AAFP **recommends** screening for high blood pressure in adults aged **18 and older**.
68
Coronary Heart Disease, Adults
The AAFP recommends **against** screening with resting or exercise EKG for the prediction of CAD events in **asymptomatic** adults at **low risk** for CAD events.
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening with resting or exercise ECG for the prediction of CAD events in **asymptomatic** adults at **intermediate** or **high risk** for CAD events.
69
Obesity, Adults (Screening for and Management)
The AAFP **recommends** screening **all** adults for obesity. Clinicians should offer or refer patients with a **BMI of 30 or higher** to intensive, multicomponent **behavioral interventions**.
70
Hemochromatosis
The AAFP recommends **against** routine genetic screening for hereditary hemochromatosis in the asymptomatic general population.
71
Phenylketonuria, Newborn
The AAFP **recommends** ordering screening test for PKU in neonates
72
Depression, Children and Adolescents
The AAFP **recommends** screening of adolescents (**12-18** y.o.) for major depressive disorder when systems are in place to ensure accurate diagnosis, psychotherapy (CBT or interpersonal), and follow-up.
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening of children (**7-11** years of age)
73
Immunization, Children and Adolescent, Catch-up
The AAFP **recommends** immunizing children **0-18** who are between doses for vaccinations with the AAFP recommendation unless contraindicated.
74
Hepatitis B Virus Infection, Pregnant Women
The AAFP **recommends** screening for HBV in pregnant women at their **first prenatal visit.**
75
Testicular Cancer
The AAFP recommends **against** screening for testicular cancer in asymptomatic adolescent or adult males
76
Dental Caries, in Children from Birth through Age 5 Year
The AAFP **recommends** that PCPs prescribe oral fluoride supplementation starting at age **6 months** for children whose **water supply is deficient in fluoride**.
The AAFP **recommends** that PCPs apply fluoride varnish to the primary teeth of **all** infants and children starting at the age of **primary tooth eruption**.
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of routine screening examinations for **dental caries** performed by PCPs in children from **birth to age 5** years.
77
Gonorrhea, Women
The AAFP **recommends** screening for chlamydia and gonorrhea in **sexually active** women age **24 years and younger** and in **older women who are at increased risk** for infection.
78
Prostate Cancer
The AAFP recommends **against** PSA-based screening for prostate cancer.
79
Preeclampsia, Low-Dose Aspirin
The AAFP **recommends** the use of low-dose aspirin (81 mg/d) as preventive medication **after 12 weeks** of gestation in women who are at **high risk for preeclampsia**.
80
Coronary Heart Disease Risk Assessment, Using Nontraditional Risk Factors
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of using the nontraditional risk factors discussed in this statement to screen **asymptomatic** men and women with **no history of CAD** to prevent CAD events.
[The nontraditional risk factors included in this recommendation are high-sensitivity C-reactive protein, ankle-brachial index, leukocyte count, fasting blood glucose level, periodontal disease, carotid intima-media thickness , coronary artery calcification score on electron-beam computed tomography, homocysteine level, and lipoprotein(a) level.]
81
Iron deficiency Anemia, Pregnant Women
The AAFP **recommends** routine screening for iron deficiency anemia in asymptomatic pregnant women.
82
Cardiovascular Disease, Aspirin for the Prevention of
The AAFP **recommends** the use of aspirin for **men age 45 -79** and **women 55-79** when the potential benefit due to a reduction in **MI** outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
The AAFP **recommends** the use of aspirin for **women age 55-79** when the potential benefit of a reduction in **ischemic strokes** outweighs the potential harm of an increase in gastrointestinal hemorrhage.
The AAFP concludes that the evidence is **insufficient** to assess the benefits and harms of aspirin for cardiovascular disease prevention in **men and women 80 years or older**
83
Hepatitis B Virus Chronic Infection
The AAFP recommends **against** routinely screening the general **asymptomatic** population for chronic HBV infection.
84
Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of CVD and Cancer
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of the use of multivitamins for the prevention of CVD or cancer.
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (**with the exception of beta-carotene and vitamin E**) for the prevention of CVD or cancer.
The AAFP recommends **against** the use of **beta-carotene or vitamin E** supplements for the prevention of CVD or cancer.
85
Bacterial Vaginosis, Pregnant Women
The AAFP **recommends against** screening for bacterial vaginosis in asymptomatic pregnant women at **low risk for preterm delivery.**
86
Hepatitis C Virus Infection, Adults
The AAFP **recommends** screening for HCV infection in persons at **high risk** for infection.
The AAFP also **recommends** offering one-time screening for HCV infection to **adults born between 1945 and 1965.**
87
Gonorrhea, Men
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men.
88
Tobacco Use, Pregnant Women
The AAFP **recommends** that clinicians screen **all** pregnant women about tobacco use and provide augmented, pregnancy-tailored **counseling** to those who smoke.
89
Dementia, Adults
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for cognitive impairment.
90
Lipid Disorders, infants, children, adolescents, and young adults
The AAFP concludes that the evidence is **insufficient** to recommend for or against routine screening for lipid disorders in infants, children, adolescents, or young adults (**up to age 20**)
91
Hypertension, Children and Adolescents
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for primary hypertension in asymptomatic children and adolescents to prevent subsequent cardiovascular disease in childhood or adulthood.
92
Chlamydia, Women
The AAFP **recommends** screening for chlamydia and gonorrhea in **sexually active** women age **24 years and younger** and in **older women at increased risk** for infection
93
Carotid Artery Stenosis, Adults
The AAFP recommends **against** screening for **asymptomatic** carotid artery stenosis in general adult populations.
94
Kidney Disease, Chronic Screening
The AAFP concludes that the evidence is **insufficient** to assess the balance of benefits and harms for routine screening for CKD in asymptomatic adults. Common tests considered for CKD screening include creatinine-derived estimates of GFR and urine testing for albumin.
95
Congenital Hypothyroidism
The AAFP **recommends** screening for congenital hypothyroidism in newborns.
96
Cardiovascular Disease, Genomic Testing
The AAFP recommends **against** genomics profiling to assess risk for cardiovascular disease. The net health benefit from the use of any genomic tests for the assessment of cardiovascular disease risk is negligible and there is no evidence that they lead to improved patient management or increased risk reduction.
97
Lung Cancer
The AAFP concludes that the evidence is **insufficient** to recommend for or against screening for lung cancer with **CT** in persons at **high risk** for lung cancer based on age and smoking history.
98
Diabetes, Type 2, Adults
The AAFP **recommends** screening for type 2 diabetes in asymptomatic adults with sustained **BP** **\> 135/80** mm Hg (either treated or untreated).
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for type 2 diabetes in asymptomatic adults with BP of **135/80 mm Hg or lower**.
99
Suicide, Screening
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for suicide risk in adolescents, adults, and older adults in primary care.
100
Abdominal Aortic Aneurysm, Women
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA in women ages 65 to 75 years who have ever smoked.
The AAFP recommends against routine screening for AAA in women who have never smoked.
101
Immunization, Children and Adolescent
The AAFP **recommends** immunizing **all children 0-18** using the AAFP recommendations unless contraindicated
102
Breast Cancer/BRCA Mutation Testing
The AAFP recommends that PCPs screen women who have **family members with breast, ovarian, tubal, or peritoneal cancer** with **screening tools** designed to identify a family history that may be associated with an increased risk for potentially harmful mutations in breast cancer susceptibility genes (BRCA1 or BRCA2). Women with **positive screening results** should receive **genetic counseling** and, if indicated after counseling, BRCA testing.
The AAFP recommends **against** routine genetic counseling or BRCA testing for women whose **family history is not associated with an increased risk** for potentially harmful mutations in the BRCA1 or BRCA2 genes.
103
Abuse, Intimate Partner Violence of Elderly and Vulnerable Adults
The AAFP **recommends** that clinicians screen **women of childbearing age** for intimate partner violence and provide or refer women who screen positive to intervention services. This recommendation applies to women who do not have signs or symptoms of abuse
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening all **elderly and vulnerable adults** for abuse and neglect
104
Vitamin D and Calcium Supplementation, Prevention of Fractures in Noninstitutionalized Postmenopausal Women
The AAFP concludes that the current evidence is **insufficient** to assess the balance of the benefits and harms of daily supplementation with \>400 IU of vitamin D3 and 1,000 mg of calcium for the primary prevention of fractures in noninstitutionalized **postmenopausal** women.
The AAFP recommends **against** daily supplementation with **≤400 IU of vitamin D3** and **1,000 mg of calcium** carbonate for the primary prevention of fractures in noninstitutionalized **postmenopausal** women.
105
Hemoglobinopathies, Newborns
The AAFP **strongly recommends** ordering screening tests for **PKU, hemoglobinopathies, and thyroid** function abnormalities in neonates.
106
Low Back Pain, Adults
The AAFP concludes that the evidence is **insufficient** to recommend for or against routine use of **interventions to prevent low back pain** in adults in primary care settings.
107
Hormone Replacement Therapy
The AAFP recommends **against** the use of combined **estrogen and progestin** for the prevention of chronic conditions in **postmenopausal** women.
The AAFP recommends **against** the use of **estrogen** for the prevention of chronic conditions in postmenopausal women who have had a **hysterectomy.**
[This recommendation applies to postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions. This recommendation does not apply to women younger than age 50 years who have undergone surgical menopause. This recommendation does not consider the use of hormone therapy for the management of menopausal symptoms, such as hot flashes or vaginal dryness.]
108
Lead Poisoning, Pregnant Women
The AAFP recommends **against** routine screening for elevated blood levels in asymptomatic pregnant women.
109
HIV Infection, Adolescents and Adults
The AAFP **recommends** that clinicians screen adolescents and adults ages **18-65** for HIV infection. **Younger adolescents and older adults** who are at **increased risk** should also be screened.
[The AAFP’s recommendation differs from USPSTF only on the age to initiate routine screening for HIV. The **USPSTF** recommends routine screening beginning at age **15 years**]
110
Healthful Diet and Physical Activity for Cardiovascular Disease
Although the correlation among healthful diet, physical activity, and the incidence of cardiovascular disease is strong, existing evidence indicates that the health benefit of initiating behavioral counseling in the primary care setting to promote a healthful diet and physical activity is **small**. Clinicians may choose to **selectively** counsel patients rather than incorporate counseling into the care of all adults in the general population. Considerations: General adult population without a known diagnosis of HTN, DM, HLD, or CVD. Issues to consider include other risk factors for cardiovascular disease, a patient's readiness for change, social support and community resources that support behavioral change, and other health care and preventive service priorities.
111
Hepatitis B Virus Infection, in Nonpregnant Adolescents and Adults
The AAFP **recommends** screening for HBV infection in persons at **high risk** for infection.
112
Behavioral Counseling to Prevent Sexually Transmitted Infections
The AAFP **recommends** high-intensity behavioral counseling to prevent STIs for **all sexually active adolescents** and for **adults at increased risk** for STIs.
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of behavioral counseling to prevent STIs in **non-sexually active** adolescents and in **adults not at increased risk** for STIs.
113
Colorectal cancer, genomic testing
The AAFP **recommends** offering genetic testing for Lynch syndrome to patients **newly diagnosed with CRC** to reduce morbidity and mortality **in relatives.** Genetic testing should be offered to **first degree relatives** of those found to **have Lynch syndrome**, and those positive for Lynch syndrome should be offered **earlier and more frequent screening** for colorectal cancer.
114
Osteoporosis, Men
The AAFP concludes that the current evidence is **insufficient** to assess the balance of benefits and harms of screening for osteoporosis in men.
115
Pulmonary Chronic Obstructive Disease
The AAFP recommends **against** screening asymptomatic adults for COPD using spiromtery.
116
Screenings that are strongly recommended
Gonococcal Infection in Neonates, Ocular Topical Medication
Hemoglobinopathies, Newborns
Rh (D) Incompatibility, Pregnant Women
Second hand smoke, exposure, children
Syphilis in pt's at increased risk
117
Recommended screenings
One-time screening for AAA by USG in men ages 65 to 75 years who have ever smoked
Women of childbearing age for intimate partner violence
Adults aged 18 years or older for alcohol misuse
Asymptomatic bacteriuria with urine culture for pregnant women at 12 to 16 weeks’ gestation or at the first prenatal visit
Offering or referring adults who are overweight or obese and have additional CVD risk factors to intensive behavioral counseling
High-intensity behavioral counseling to prevent STIs for all sexually active adolescents and for adults at increased risk
Biennial screening mammography for women between ages 50 and 74
Women who have family members with breast, ovarian, tubal, or peritoneal cancer with screening tools designed to identify a family history associated with an increased risk for BRCA1/BRCA2
Interventions during pregnancy and after birth to promote and support breastfeeding.
ASA for men age 45 to 79 years and women age 55 to 79 years
Cervical cancer in women age 21 to 65 years with cytology every 3 years or women age 30 to 65 years with cytology and HPV testing every 5 years
Chlamydia and gonorrhea in sexually active women age 24 years and younger and in older women who are at increased risk
CRC beginning at age 50 years and continuing until age 75 years
Offering genetic testing for Lynch syndrome to patients newly diagnosed with colorectal cancer
Congenital hypothyroidism in newborns
Prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride
Apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption
Screening adults for depression when staff-assisted depression care supports are in place
Screening adolescents 12-18 years of age for major depressive disorder when systems are in place
Gestational diabetes mellitus in asymptomatic pregnant women after 24 weeks
Screening for type 2 diabetes in asymptomatic adults with BP\> 135/80
Exercise/PT and vitamin D supplementation in community-dwelling adults aged 65 years or older who are at increased risk for falls
Hearing loss in all newborn infants
HBV in pregnant women at their first prenatal visit
HBV infection in persons at high risk for infection
HCV infection in persons at high risks for infection
Adolescents and adults ages 18 to 65 years for HIV infection
All pregnant women for HIV
High blood pressure in adults aged 18 and older
Immunizing all patients using the AAFP recommendations unless contraindicated
Iron deficiency anemia in asymptomatic pregnant women
Men aged 35 and older for lipid disorders
Men 20-35 or women \> 20 for lipid disorders if they're at increased risk
All women planning/capable of pregnancy take a daily supplement containing 400-800 µg of folate
All adults for obesity and referring those with BMI \> 30 for interventions
Children aged 6 years and older for obesity and referral to intervention if obese
Osteoporosis in women aged 65 years or older and in younger women whose fracture risk is equal to or greater than that of a 65-year old white woman
Phenylketonuria in neonates
ASA 81mg as preventive medication after 12 weeks in women who are at high risk for preeclampsia
Repeat Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24-28 weeks
Intensive behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs
Counseling children, adolescents, and young adults ages 10-24 years who have fair skin about minimizing their exposure to UV radiation
All pregnant women for syphilis
All adults for tobacco use and provide tobacco cessation interventions
Provide interventions, including education or brief counseling, to prevent initiation of tobacco use among school-aged children and adolescents
Vision screening for all children at least once between the ages of 3 and 5 years
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Things we definitely shouldn't screen for/do
(recommended against)
AAA in women who have never smoked
Asymptomatic bacteriuria in men and nonpregnant women
BV in asymptomatic pregnant women at low risk for preterm delivery
Teaching women Breast Self-Examination
Routine use of medications, such as tamoxifen or raloxifene, for risk reduction of primary breast cancer in women who are not at increased risk
Genetic counseling or BRCA testing for women whose family history is not associated with an increased risk
ASA for stroke prevention in women
Genomics profiling to assess risk for cardiovascular disease
Asymptomatic carotid artery stenosis
Cervical cancer in women younger than age 21 years
Cervical cancer in women \> 65 years who have had adequate prior screening and are not otherwise at high risk
Cervical cancer in women who have had a hysterectomy with removal of the cervix and without history of HSIL
HPV testing, alone or in combination with cytology, in women
Asymptomatic adults for COPD using spirometry
CRC in adults age 76-85 years unless indicated or adults \> 85
ASA/NSAIDs to prevent CRC in individuals at average risk
Resting or exercise EKG for the prediction of CAD events in asymptomatic adults at low risk
Serological screening for HSV in asymptomatic pregnant women or other adults
Genetic screening for hereditary hemochromatosis
Asymptomatic population for chronic HBV infection
Combo estrogen and progestin for the prevention of chronic conditions in postmenopausal women
Estrogen for the prevention of chronic conditions in postmenopausal women after hysterectomy
Asymptomatic adolescents for idiopathic scoliosis
Immune marker screening for IDDM
Elevated lead levels in asymptomatic children aged 1-5 years or pregnant women who are at average risk
Ovarian cancer
Pancreatic cancer
PSA for prostate CA
Hypercoagulable diseases in pt's with family members with VTE
Persons who are not at increased risk for syphilis
Testicular cancer
Ultrasound screening for thyroid cancer
Beta-carotene or vitamin E for the prevention of CVD or cancer
≤400 IU of vitamin D3 and 1,000 mg of calcium carbonate for the primary prevention of fractures in noninstitutionalized postmenopausal women
119
Things to screen/do for preggos
Asymptomatic bacteriuria with urine culture (12-16 weeks or first visit)
Gestational diabetes (after 24 weeks)
HBV (at first visit)
HIV
Iron deficiency anemia
Rh blood typing and antibody testing (at first visit)
Repeat Rh testing for Rh- moms (at 24-28 weeks)
Syphilis
Tobacco use + provide smoking cessation counseling to those ratchets who smoke
120
