2-Preventive Screening Flashcards
What are the requirements for screening?
Condition screened should be common
Condition screened can be discovered before disease manifests with symptoms
Effective treatment exists for the disease
Early treatment reduces morbidity,mortality
Screening should be cost effective
What are the benefits of screening ?
Prevention and screening can be less costly than treatment of disease
Disease avoidance is better health policy
Less advanced disease is generally easier to treat
What are the disadvantages of screening ?
Too much money spent tracking down false positives
False positives lead to high cost of testing and insurance premiums, and anxiety
False negative lead to failure to diagnose
What is the number needed to screen?
Similar to number needed to treat
Number of people needed to screened over a given duration to prevent one death or adverse event
What are the STD that are screened?
Chlamydia trachomatis- most common bacterial STD in the US
Gonnorrhea
Why screen for the STD?
To prevent :
Pelvic inflammatory disease that can lead to scarring and ectopic pregnancy
Chronic pelvic pain
Infertility
Who is screened for STD?
All patients under the age of 26
Patients over 26 who have risk factors predisposing to disease
Who is screened for breast cancer? And how often?
Women between the ages of 50-74
Mammography every 1-2 years
Breast physical exam by provider every 3 years starting at age 20
Consider genetic testing (brca) for high risk
Who is screened for colorectal cancer? And how often?
50-86 years old for average risk patients
10 years earlier than age of 1st degree relative age of diagnosis for high risk patients
Many modalities available with different time frames
Gold standard is full colonoscopy q 10years
Who is screened for ovarian cancer?
No evidence that screening is cost effective for low risk women
Start at age 35 or 5-10 years earlier before youngest cancer diagnosis for high risk patients with genetic testing and ultrasound q 6-12 months
Who is screened for cervical cancer? How often? And modalities used?
Pap smears should start at age 21
Repeat every 3 years for normal pap smear between age of 21-30
No HPV testing in that age group
At 30 every 5 years when pap smears done with HPV testing
Stop testing at age 65 or after hysterectomy for non malignant disease
Why uterine cancer is not screened for?
Endometrial cancer is always diagnosed after an episode of dysfunctional uterine bleeding (DUB)
Biopsy is part of work up of DUB
Who is screened for osteoporosis? And how often?
Post menopausal women over the age of 65 with fracture risk similar to or more than a 65 year old caucasian women
Q3-5 years with osteopenia
Q10-15 years with T score low normal of -1 to -1.49
