Screening Tests Flashcards
Digital rectal exam and PSA test
For men aged 55 to 69 years, do not routinely screen for prostate cancer using a prostate-specific antigen (PSA) test or digital rectal exam. For men who desire PSA screening, it should only be performed after engaging in shared decision making.
PSA prostate cancer screening should not be preformed in men over 70yo
Pap-screening
Do not screen for cervical cancer in women younger than 21. Do not screen with HPV testing alone or in combo in women younger than 30 years old. Can stop screening women 65 and older who have had adequate prior screening and not at high risk.
The USPSTF recommends screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and HPV testing every 5 years.
If 65 or older with hx of CIN2, CIN3, or adenocarcinoma in situ, then screening should be done for at least 20 years.
If have had total hysterectomy (uterus and cervix) no longer need screening. If had supra-cervical hysterectomy (cervix intact) should continue per guidelines.
Endometrial biopsy
Evaluation for endometrial neoplasia in women with abnormal uterine bleeding or specific cervical cytology results. Women who have undergone uterus-sparing therapy for endometrial cancer should, at the least, have regular endometrial sampling.The only absolute contraindication to endometrial sampling is the presence of a viable and desired pregnancyIn the presence of acute vaginal, cervical, or pelvic infection, the procedure should be deferred, if possible, until the infection has been treated.
Lung cancer screening
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 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.
Breast Cancer Screening
The USPSTF recommends biennial (every 2 years) screening mammography for women aged 50 to 74 years.
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.
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.
Abdominal Aortic Aneurysm Screening
The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked.
BRCA Related Cancer Screening
The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing.
Osteoporosis Screening
The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.
The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool.
