RACGP Red Book Screening Guidelines Flashcards
What age range should opportunistic STI screening be performed?
15 - 29 year olds
Who are high risk STI populations and how often should they be screened?
High risk: aboriginal or TSI, IVDU, sex workers, MSM
Screening: annually
How often should absolute CVD risk be assessed?
- every 2 years from age 45
- unless aboriginal or TSI, need to screen every 2 years from age 35
What components are required to calculate absolute CVD risk? (8)
Age, sex, smoking status, total and HDL cholesterol, SBP, diabetes and LVH
Cholesterol aims for primary prevention of CVD
Total cholesterol < 4 HDL > 1 LDL < 2 Non-HDL < 2.5 TG < 2
How often should cholesterol be assessed/screened?
Screening every 5 years from 45 or 35 if aboriginal ort TSI
Cholesterol screening in low, moderate and high risk CVD groups
Low risk: screen every 5 years
Moderate risk: Consider pharmacotherapy if not reaching targets in 6 months or if family history of premature CVD
High risk: commence rx + antihypertensive
What is AUSDRISK?
Screening tool for risk of developing diabetes, should be done every 3 years in patients over 40 or aboriginal or TSI patients > 18.
How often should HbA1c screening be performed in patients with impaired glucose tolerance?
Annually with a fasting glucose
Which patients fall into the high risk for diabetes category and how often should HbA1c be performed?
High risk: age > 40 and BMI > 25, AUSDRISK score >12
Screening: either fasting glucose/HbA1c every 3 years
Fasting glucose interpretation
< 5.5mmol/L = diabetes unlikely
5.5 – 6.9mmol/L = perform OGTT
> 7mmol/L (or >11.1 non-fasting) = diabetes likely, repeat on separate date to confirm
Risk factors for kidney disease (9)
Smoking, BMI > 30, diabetes, HTN, Aboriginal or TSI over 30 years old, PVD, CVD >60yo Hx of AKI
Describe the screening for patients at risk of kidney diease
Patients should be screened every 1-2 years with blood pressure check and urine ACR.
Interpreting urinary ACR results
Normal: < 3.5mg/mmol in women, < 2.5mg/mmol in men
Microalbuminuria: 3.5-35mg/mmol in women, 2.5-25mg/mmol in men
Macroalbuminuria: > 35mg/mmol in women, > 25mg/mmol in men
Describe the rationale behind screening for prostate cancer in men (as per Redbook).
No obligation to screen asymptomatic men for PSA
Benefit vs risks
- Risk of over diagnosis & rx, impotence + incontinence
DRE is no longer recommended as it is insufficiently sensitive to detect prostate cancers early enough
High risk: Men with one or more first-degree relatives diagnosed
Describe the categories of risk with colorectal cancer. (Cat 1/2/3)
Cat 1: average risk
- Asymptomatic people with no family history
- Fhx of a 1st or 2nd degree relative with CRC > age 55
Cat 2: moderate risk
- Asymptomatic patients with FHx of CRC < age 55
- 2 x first degree or 1 x first degree + 1 x second degree relative on same side of family with CRC diagnosed at any age
Cat 3: high risk
- Suspicion or confirmed familial polyposis syndrome
(3x 1st or 2nd degree relatives on the same side)
(2x 1st or 2nd degree relatives on the same side with high risk features)
(1x 1st or 2nd degree relative with FAP or microdeletion tumours)
Describe the screening for CRC in category 1, 2 and 3 patients.
Cat 1 (average risk)
- FOBT screening every 2 years from > 50 until age 75
- Actively consider aspirin 100-300mg/day prophylaxis
Cat 2 (moderate risk)
- iFOBT every 2 years from 40-49
- Colonoscopy every 5 years from 50 to 74yo
- Actively consider aspirin 100-300mg/day prophylaxis
Cat 3 (high risk)
- iFOBT every 2 years from 35-44yo
- colonoscopy from 45-74yo
- Refer for genetic screening
- Refer to bowel cancer specialist
- Suggest aspirin 100-300mg/day prophylaxis
