Preventive Services Guidelines, 2014

The following recommendations of the U.S. Preventive Services Task Force:

The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians discuss these preventive services with eligible patients and offer them as a priority. All these services have received an "A" or a "B" (recommended) grade from the Task Force.

Recommendations. U.S. Preventive Services Task Force, current as of September 2014 http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm

Recommendation

Adults

Special Populations

Notes

Men

Women

Pregnant Women

Children

Abdominal Aortic Aneurysm, Screening

X

 

 

 

One-time screening by ultrasonography in men aged 65 to 75 who have ever smoked.

Alcohol Misuse Screening and Counseling

X

X

X

 

The USPSTF recommends that clinicians screen adults age 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.

 

Aspirin for the Prevention of Cardiovascular Disease

X

X

 

 

When the potential harm of an increase in gastrointestinal hemorrhage is outweighed by a potential benefit of a reduction in myocardial infarctions (men aged 45-79 years) or in ischemic strokes (women aged 55-79 years).

Asymptomatic Bacteriuria in Pregnant Women

 

 

X

 

Pregnant women at 12-16 weeks gestation or at first prenatal visit, if later.

Breast Cancer, Screening

 

X

 

 

Biennial screening mammography for women aged 50 to 74 years. Note: The Department of Health and Human Services, in implementing the Affordable Care Act, follows the 2002 USPSTF recommendation for screening mammography, with or without clinical breast examination, every 1-2 years for women aged 40 and older.

Note:  See recommendations below from the American Cancer Society.

Breast Cancer Preventive Medications

 

X

 

 

The USPSTF 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.

Breast and Ovarian Cancer Susceptibility, Genetic Risk Assessment and BRCA Mutation Testing

 

X

 

 

Refer women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes for genetic counseling and evaluation for BRCA testing.

Breastfeeding, Primary Care Interventions to Promote

 

X

X

 

Interventions during pregnancy and after birth to promote and support breastfeeding.
 

Cervical Cancer, Screening

 

X

 

 

Screen with cytology every 3 years (women ages 21 to 65) or co-test (cytology/ HPV testing) every 5 years (women ages 30-65).

 

Chlamydial Infection, Screening

 

X

X

 

Sexually active women 24 and younger and other asymptomatic women at increased risk for infection. Asymptomatic pregnant women 24 and younger and others at increased risk.

Cholesterol Abnormalities, Screening

X

X

 

 

The USPSTF strongly recommends screening men age 35 years and older for lipid disorders, men ages 20 to 35 years for lipid disorders if they are at increased risk for coronary heart disease, women age 45 years and older for lipid disorders if they are at increased risk for coronary heart disease, and women ages 20 to 45 years for lipid disorders if they are at increased risk for coronary heart disease.

Colorectal Cancer, Screening

X

X

 

 

Adults aged 50-75 using fecal occult blood testing, sigmoidoscopy, or colonoscopy.

Depression Screening

X

X

 

 X

Screening for adults and adolescents (ages 12-18 years) for major depressive disorder when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up.

Diabetes Mellitus (Type 2) in Adults, Screening

X

X

 

 

Asymptomatic adults with sustained blood pressure greater than 135/80 mg Hg.

 

Falls Prevention in Older Adults: Exercise or Physical Therapy

X

X

 

 

The USPSTF recommends exercise or physical therapy to prevent falls in community-dwelling adults age 65 years and older who are at increased risk for falls.

Falls Prevention in Older Adults: Vitamin D

X

X

 

 

The USPSTF recommends vitamin D supplementation to prevent falls in community-dwelling adults age 65 years and older who are at increased risk for falls.

Folic Acid to Prevent Neural Tube Defects

 

X

 X

 

All women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8.mg (400 to 800 µg) of folic acid.

Gonorrhea, Screening

 

X

 X

 

Sexually active women, including pregnant women 25 and younger, or at increased risk for infection.

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.

 

Hepatitis B Virus in Pregnant Women, Screening

 

 

X

 

Screen at first prenatal visit.
 

Hepatitis B Virus Infection in Non-Pregnant Adolescents and Adults, Screening

 

X

 

X

The USPSTF recommends screening for hepatitis B virus infection in persons at high risk for infection.

 

Hepatitis C Virus Infection Screening: Adults

X

X

 

 

The USPSTF recommends screening for hepatitis C virus (HCV) infection in persons at high risk for infection. The USPSTF also recommends offering one-time screening for HCV infection to adults born between 1945 and 1965.

 

High Blood Pressure (Adults), Screening

X

X

 

 

Screening for high blood pressure in adults age 18 years and older.

 

HIV, Screening

X

X

X

X

All adolescents and adults at increased risk for HIV infection and all pregnant women.
 

Intimate Partner Violence Screening: Women of Childbearing Age

 

X

 

 

The USPSTF recommends that clinicians screen women of childbearing age for intimate partner violence, such as domestic 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.

 

Iron Deficiency Anemia, Screening

 

 

X

 

Routine screening in asymptomatic pregnant women.
 

Lung cancer screening

 

X

X

 

 

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography in adults ages 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

 

Obesity Screening and Counseling: Adults

X

X

 

 

The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.

 

Osteoporosis, Screening

 

X

 

 

Women aged 65 years and older and women under age 65 whose 10-year fracture risk is equal to or greater than that of a 65-year-old white woman without additional risk factors.

Rh (D) Incompatibility, Screening

 

 

X

 

Blood typing and antibody testing at first pregnancy-related visit. Repeated antibody testing for unsensitized Rh (D)-negative women at 24-28 weeks gestation unless biological father is known to be Rh (D) negative

Sexually Transmitted Infections, Counseling

X

X

 

X

All sexually active adolescents and adults at increased risk for STIs.

Skin Cancer Behavioral Counseling

X

X

 

X

The USPSTF 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 for skin cancer.

 

Syphilis Infection, Screening

X

X

X

 

Persons at increased risk; and all pregnant women

Tobacco Use and Tobacco-Caused Disease, Counseling and Interventions

X

X

X

 X

Ask all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco; provide augmented, pregnancy-tailored counseling for those pregnant women who smoke; provide interventions, including education or brief counseling, to prevent initiation of tobacco use in school-aged children and adolescents.

Note:  This chart does NOT include USPSTF Recommendations specific to children.  Please see the following website for more information regarding recommendations for children ages 0-21:

                          http://www.uspreventiveservicestaskforce.org/tfchildcat.htm

Individuals should discuss preventive health care with their primary care provider. 

Additional preventive care guidelines from specialty organizations:

American Cancer Society Guidelines for the Early Detection of Breast Cancer (updated 2013)

  • Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health
  • Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over
  • Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
  • Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

American Urological Association Guidelines for the Early Detection of Prostate Cancer (updated 2013)

  • Guideline Statement 1: The Panel recommends against PSA screening in men under age 40 years. (Recommendation; Evidence Strength Grade C)
    • In this age group there is a low prevalence of clinically detectable prostate cancer, no evidence demonstrating benefit of screening and likely the same harms of screening as in other age groups.
  • Guideline Statement 2: The Panel does not recommend routine screening in men between ages 40 to 54 years at average risk. (Recommendation; Evidence Strength Grade C)
    • For men younger than age 55 years at higher risk (e.g. positive family history or African American race), decisions regarding prostate cancer screening should be individualized.
  • Guideline Statement 3: For men ages 55 to 69 years the Panel recognizes that the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the known potential harms associated with screening and treatment. For this reason, the Panel strongly recommends shared decision-making for men age 55 to 69 years that are considering PSA screening, and proceeding based on a man's values and preferences. (Standard; Evidence Strength Grade B)
    • The greatest benefit of screening appears to be in men ages 55 to 69 years.
  • Guideline Statement 4: To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision-making and decided on screening. As compared to annual screening, it is expected that screening intervals of two years preserve the majority of the benefits and reduce over-diagnosis and false positives. (Option; Evidence Strength Grade C)
    • Additionally, intervals for rescreening can be individualized by a baseline PSA level.
  • Guideline Statement 5: The Panel does not recommend routine PSA screening in men age 70+ years or any man with less than a 10 to 15 year life expectancy. (Recommendation; Evidence Strength Grade C)
    • Some men age 70+ years who are in excellent health may benefit from prostate cancer screening.

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 These clinical guidelines are subject to change without notice and may not represent the most current information available. The Plan makes no warranties or guarantees concerning or related to these guidelines, and will not be held liable for any deficiencies with regard to guidelines either referenced or not referenced, or for any inaccuracies or recommendations made by independent third parties who have relied on this information.

Last Updated: 09/22/2014