USPSTF Screening Guidelines Flashcards
Grade A
Recommends- high certainty that net benefit is substantial
Grade B
Recommends- high certainty that net benefit is moderate
Grade C
Selectively offer this service on individual basis, net benefit is small
Grade D
Recommend against- no benefit or harm outweighs benefit
Grade I
insufficient evidence to assess risks/benefits
Atrial Fib: screening adults with EKG
Grade I: insufficient evidence
Abdominal aortic aneurysm: screening adults
- men age 65-75 who have ever smoked
- men age 65-75 who have never smoked
- women age 65-75 who have ever smoked
- women who have never smoked
M smokers 65-75: Grade B- one lifetime U/S
M nonsmokers 65-75: Grade C- selectively offer
F smokers 65-75: Grade I- insufficient evidence
F nonsmokers: Grade D- recommend against
Abnormal blood glucose and DM2: screening adults
Grade B: screen adults age 40-70 who are overweight or obese.
- Promote healthy diet and physical activity.
- If obvious signs of diabetes, screen regardless.
- If + fmhx or PCOS or gestation DM or minority race then screen earlier.
Adolescent idiopathic scoliosis
Grade I: insufficient evidence for screening ages 10-18
Aspirin to prevent CVD and colon cancer: screening adults
- age < 50
- age 50-59 with > 10% 10 year CVD risk
- age 60-69 with > 10% 10 year CVD risk
- age > 70
- age < 50: Grade I- insufficient evidence
- age 50-59 with > 10% risk: Grade B- initiate low dose ASA for primary prevention of CVD and colon cancer if no increased risk of bleed, life expectancy > 10 years, willing to take for at least 10 years
- age 60-69 with > 10% risk: Grade C- weigh risks and benefits on individual basis, selectively offer
- age > 70: Grade I- insufficient evidence
Asymptomatic bacteriuria: screening adults
- pregnant women
- men and non pregnant women
- pregnant women: Grade A- urine culture at 12-16 weeks or first prenatal visit if later
- men and non pregnant women: Grade D- recommend against
Autism spectrum disorder: screening in children
Grade I- insufficient evidence to screen children 18-30 months for whom no concerns of ASD have been raised by parents or clinician
Bacterial vaginosis in pregnancy: screening to prevent preterm delivery
- asymptomatic pregnant women with low risk
- asymptomatic pregnant women with high risk
- asymptomatic pregnant F with low risk: Grade D- recommend against
- asymptomatic pregnant F with high risk: Grade I- insufficient evidence
Bladder cancer: screening in adults
Grade I- insufficient evidence to screen asymptomatic adults
Blood pressure: screening in children and adolescents
Grade I- insufficient evidence to support screening in asymptomatic children and adolescents
BRCA related cancer: risk assessment, genetic counseling, and genetic testing
- Women with family members affected family members
- Women with no fmhx
- WITH fmhx: Grade B- screen women with fmhx breast, ovarian, tubal, or peritoneal cancer with one of several screening tools. If positive screening results then refer to genetic counseling. If indicated after counseling, then BRCA test.
- WITHOUT fmhx: Grade D- recommend against routine genetic counseling or BRCA testing
Breast cancer: medications for risk reduction
- women at increased risk
- women at no increased risk
- women at increased risk: Grade B- shared decision making, if benefits outweigh risks then offer meds such as tamoxifen/raloxifene
- women at no increased risk: Grade D- recommend against routine use
Breast cancer: screening
- women age 40-49
- women age 50-74
- women age > 75
- digital breast tomosynthesis (DBT)
- women with dense breasts
- age 40-49: Grade C- screen selectively
- age 50-74: Grade B- recommend biennial screening mammogram
- age > 75: Grade I
- digital breast tomosynthesis: Grade I for primary screening method
- women with dense breasts: Grade I for adding imaging such as U/S, MRI, DBT if mammogram negative
Breastfeeding: primary care interventions
Grade B: recommend providing interventions during pregnancy and after birth to support breastfeeding
Cardiovascular disease risk: screening adults with EKG
- adults at low risk of CVD events
- adults with intermediate-high risk of CVD events
- low risk adults: Grade D- recommend against screening resting or exercise EKG in asymptomatic adults
- intermediate-high risk adults: Grade I- insufficient evidence for resting or exercise EKG in asymptomatic adults
Cardiovascular disease: adult risk assessment with nontraditional risk factors
Grade I- insufficient evidence to assess harms and benefits of adding ankle-brachial index, high sensitivity CRP level, or coronary artery calcium score to traditional risk assessment for CVD in asymptomatic adults
Carotid artery stenosis: screening in adults
Grade D- recommend against screening for asymptomatic carotid artery stenosis in general adult population
Celiac disease: screening
Grade I- insufficient evidence to assess pros/cons of screening for celiac disease in asymptomatic adults, adolescents, or children
Cervical cancer: screening
- age < 21
- age 21-65
- age > 65
- hx hysterectomy
- age < 21: Grade D- recommend against
- age 21-65: Grade A- For age 21-29 screen for cervical cancer Q3Y with cytology alone. For age 30-65 screen Q3Y with cytology alone, every 5 years with hrHPV alone, or Q5Y with cotesting.
- age >65: Grade D- recommend against
- hx hysterectomy: Grade D- recommend against if no cervix and no hx CIN2/3 or cervical cancer