Screening recommendations
Wonder Me!
good for 1st clinical: http://www.uspreventiveservicestaskforce.org


Blurb:
HTN: screen all adults over 18 y/o
Diabetes type 2: screen only for adults over 18 y/o w/ elevated BP >135/80
Lipid disorder (Cholesterol, Dyslipidemia): screen all men over 35 y/o regardless of risks; in women over 20 y/o w/ increased risks only; also screen men 20-35 y/o if w/ increased risks
Colorectal cancer: all over 50 y/o - 75 y/o; 75-85 y/o: maybe individual choices; over 85: do NOT screen
Breast cancer:
screen any women w/ family members w/ breast, ovarian, tubal, or peritoneal cancer
screen women starting at 40 y/o if parent or sibling w/ breast cancer
may not screen women starting at 40 y/o w/ no risk factors due to over-diagnosis problems.
screen women starting at 50 y/o every 2 years
Thyroid: not known






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Specific details:

Summary of Recommendations for HTN 

PopulationRecommendationGrade
(What's This?)
Adults with Elevated Blood Pressure 
The USPSTF recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg.
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.
Asymptomatic Adults, Not Elevated Blood Pressure 
The USPSTF 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 blood pressure of 135/80 mm Hg or lower.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

Summary of Recommendations for Lipid disorders - Screening Men 

PopulationRecommendationGrade
(What's This?)
Men 35 and Older 
The USPSTF strongly recommends screening men aged 35 and older for lipid disorders. 
The USPSTF recommends the service. There is high certainty that the net benefit is substantial.
Men 20-35 at Increased Risk for CHD
The USPSTF recommends screening men aged 20-35 for lipid disorders if they are at increased risk for coronary heart disease. 
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.

Summary of Recommendations for Lipid disorders- Screening Women at Increased Risk 

PopulationRecommendationGrade
(What's This?)
Women 45 and Older at Increased Risk for CHD 
The USPSTF strongly recommends screening women aged 45 and older for lipid disorders if they are at increased risk for coronary heart disease. 
The USPSTF recommends the service. There is high certainty that the net benefit is substantial.
Women 20-45 at Increased Risk for CHD
The USPSTF recommends screening women aged 20-45 for lipid disorders if they are at increased risk for coronary heart disease. 
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.
Go to the Clinical Considerations section for a discussion of "increased risk".

Summary of Recommendations for colonoscopy

PopulationRecommendationGrade
(What's This?)
Adults, beginning at age 50 years and continuing until age 75 years
The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary. 
The USPSTF recommends the service. There is high certainty that the net benefit is substantial.
Adults age 76 to 85 years
The USPSTF recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in an individual patient.
The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual patient. There is at least moderate certainty that the net benefit is small.
Adults older than age 85 years
The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years.
The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits
Computed Tomographic Colonography and Fecal DNA testing as screening modalities
The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer. 
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

Summary of Recommendations and Evidence 

PopulationRecommendationGrade
(What's This?)
Women who have Family Members with Breast, Ovarian, Tubal, or Peritoneal Cancer
The USPSTF recommends that primary care providers screen women who have family members with breast, ovarian, tubal, or peritoneal cancer with 1 of several 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 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.
Women Whose Family History is not Associated with an Increased Risk 
The USPSTF 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. 
The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits
PopulationRecommendationGrade
(What's This?)
Women aged 50 to 74 years
The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
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.
Women aged 40 to 49 years
The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years.
•   For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during ages 50 to 74 years. Of all of the age groups, women aged 60 to 69 years are most likely to avoid breast cancer death through mammography screening. While screening mammography in women aged 40 to 49 years may reduce the risk for breast cancer death, the number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger. The balance of benefits and harms is likely to improve as women move from their early to late 40s.
•   In addition to false-positive results and unnecessary biopsies, all women undergoing regular screening mammography are at risk for the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to their health, or even apparent, during their lifetime (known as “overdiagnosis”). Beginning mammography screening at a younger age and screening more frequently may increase the risk for overdiagnosis and subsequent overtreatment.
•   Women with a parent, sibling, or child with breast cancer are at higher risk for breast cancer and thus may benefit more than average-risk women from beginning screening in their 40s.
Go to the Clinical Considerations section for information on implementation of the C recommendation.
The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual patient. There is at least moderate certainty that the net benefit is small.
Women aged 75 years or older
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.
All women 
The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.
Women with dense breasts
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.
These recommendations apply to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age.
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