Recommended Preventive Screening
2011
updated 9/14/11 M Hamm (original QI Project Team Garan,
Hamm, Gedmintas)
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Age |
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21 |
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Cervical Cancer 3 years after sexually active
or>21 |
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Lipids High risk >20 years DM, CAD or PAD, earlyfamily
CV disease, tobacco, HTN, BMI >30 |
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Diabetes High risk <45 years BMI>25,
HTN, HDL<35 or TG>250, sedentary, FH of DM, AA, Latino, Asian American,
h/o gestational DM |
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For All Patients HTN BP > 140/90 on 2 readings at
least 1 week apart Obesity BMI >30, lifestyle modification Healthy Diet For pts with CV risk factors, high chol, diet related chronic disease: low sat fat, high
fruit/veg and fiber Tobacco Amount of use, type of use.
Behavioral counseling, pharmacotherapy Alcohol CAGE: cut down, angry/annoyed,
guilty, eye-opener Depression Depressed mood, loss of
interest/pleasure, change in sleep, appetite, weight, psychomotor, loss of
energy or concentration, thoughts of worthlessness, guilt, death, or suicide HIV NYC is a high prevalence area, screen
all patients Domestic Violence SAFE: Stress/safety Afraid/abused Friends/family Emergency plan DOVE 59060 Seatbelts Bike Helmets Drunk Driving STD counseling |
For High Risk Patients PPD recent TB infection, HIV, IVDU,
silicosis, prior TB on CXR, underweight, DM, CRI/HD, gastrectomy,
jejunoileal bypass, renal/cardiac transplant, head
and neck Ca GC/ChlamydiaWomen <25 years old or high risk
sexual behavior Syphillis MSM,
high risk sexual behavior, commercial sex workers, h/o correctional
facilities Hep B screenpregnant women Rubella Screenwomen of childbearing age:hx of vaccination or serology ASA for primary prevention of CV
events for patients with 10 year CHD risk
>6%: 75 mg ASA daily |
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21-30yo q2yrs if normal 31-65yo q3yrif 3 normal paps and negative HPV testing. If TAH, no need for Pap unless TAH
for invasive cervical Ca or DES |
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35 |
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Men>35 years |
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40 |
Breast Cancer mammography > 40
years if high risk or per pt
preference |
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Prostate
Cancer 40-45 for
high risk |
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Colorectal Cancer Earlier if HNPCC, familial polyposis, UC, early family history of colon CA |
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45 |
High risk Women >45 years Test total Cholesterol and HDL
(calculated LDL) every 3-5 years |
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If HTN, high cholesterol >45 years Fasting
blood glucose > 126, Glucose tolerance test >200 after 2 hours |
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USPSTF:
insufficient evidence to assess risks,benefits
of prostate cancer screening.Discus risk/benefit, family hx, race, sx, and pt
preference. Yearly with PSA and DRE begin at age 50 No screening recommended after age
75 or if life exp. <10yrs |
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50 |
> 50
years old mammoq2
yrs USPSTF
evidence insufficient for clinical breast exams if mammo
is available Evidence
against self breast exam High Risk women: BRAC 1,2 testing
if first degree relatives with breast or ovarian CA, or men with breast CA in
family, also consider medical or surgical prophylaxis |
Women, Men > 50 years Colonoscopy every 10 years or Sigmoidoscopy every 5 years or ANNUAL FOBT |
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60 |
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Osteoporosis High risk > 60 years low
BMI, white or Asian, h/o fracture, FH of osteoporotic
fracture, falls, sedentary, smoking, excessive etoh
or caffeine use, low Ca or vit D intake |
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65 |
If history of normal Paps, can stop screening at 65 |
AAA Men >65 yr past/present smokers Abd US, if >5.5cm, surgery |
Women avg
risk > 65 years DEXA scan- interval determined
clinically. See
FRAX calculator to risk stratify |
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75 |
No
evidence for mammo after age 75 |
If history of normal testing, STOP
screening at 75, stop for all at 85 |
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85 |
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