High-Yield Facts about Screening Tests

Screening for Breast Cancer (((lower mortality))):

The USPSTF recommends biennial screening mammography for women aged 50 to 74 years every 1
2 years.
The USPSTF recommends against teaching breast self-examination (BSE).
The U.S. Preventive Services Task Force (USPSTF) recommends against routine referral for genetic
counseling or routine breast cancer susceptibility gene (BRCA) testing for women whose family history
is not associated with an increased risk for deleterious mutations in breast cancer susceptibility gene 1
(BRCA1) or breast cancer susceptibility gene 2 (BRCA2).
The USPSTF recommends that women whose family history is associated with an increased risk for
deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for
BRCA testing.
*Those are increase risk should screen at age of 40 year or 10 years before the age when a
first-degree relative was diagnosed, whichever come first.
Chemoprevention of Breast Cancer
The (USPSTF) recommends against routine use of tamoxifen or raloxifene for the primary prevention
of breast cancer in women at low or average risk for breast cancer.
The USPSTF recommends that clinicians discuss chemoprevention with women at high risk for breast
cancer and at low risk for adverse effects of chemoprevention. Clinicians should inform patients of the
potential benefits and harms of chemoprevention.
Screening for Cervical Cancer (((lower mortality))) March 2012
The USPSTF recommends screening for cervical cancer in women ages 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 human papillomavirus (HPV) testing every 5.
The USPSTF recommends against screening for cervical cancer in women younger than age 21
years.
The USPSTF recommends against screening for cervical cancer in women older than age 65 years
who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
The USPSTF recommends against screening for cervical cancer in women who have had a
hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous
lesion (i.e., cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer.
Colon cancer(((lower mortality)))
<A>- colonoscopy
*start screening after age of 50 year= every 10 years
*if there is single family member with colon cancer= begin 10 years earlier than the family member
developed their cancer or age 40, whichever is younger
* if there are 3 family member, 2 generation, or 1 premature before 50 year(HNPCC)= start screening
at age of 25 with colonoscopy every 12 years
*if there is family Hx of FAP= start screening with sigmoidoscopy at age of 12 year every year
*if the patient has previous Hx of colon cancer= patient should have colonoscopy at 1 year after
resection, then every 5 years
*All patient with confirmed colon adenomas, regardless of histological type should have full screening
colonoscopy. If <2 tubular adenoma removed may followed up with colonoscopy every 510 years. If
310 tubular adenoma or villous adenoma or high grade dysplasia should have follow-up
colonoscopy in 3 year
<B> fecal occult blood test(FOBT) + flexible sigmoidoscopy: every 5 years
<C> FOBT: every 5 years
The USPSTF recommends against the routine use of aspirin and nonsteroidal anti-inflammatory drugs
(NSAIDs) to prevent colorectal cancer in individuals at average risk for colorectal cancer.
Screening for Type 2 Diabetes Mellitus in Adults
fasting blood sugar
The USPSTF recommends screening for type 2 diabetes in asymptomatic adults with sustained blood

pressure (either treated or untreated) greater than 135/80 mm Hg.

*at age >45 year at 3 year interval
* <45 year of age with risk factor (HTN, family Hx, over weight, PCOS, Hx of gestational diabetes, low
HDL and high LDL)
In gestational Diabetes Mellitus, the best screening test is the 50 gram oral glucose tolerance test, not
the fasting glucose, and the confirmatory test is the 3 hour 100 gram glucose tolerance test.
Lipid screen:
fasting cholesterol and LDL
*Men= above 35 year
*Women=above 45 year in both done every 5 years
*in high risk patient start at age of 20 year, done every year
Screening for Carotid Artery Stenosis
The U.S. Preventive Services Task Force (USPSTF) recommends against screening for asymptomatic
carotid artery stenosis (CAS) in the general adult population.
Aspirin for the Prevention of Cardiovascular Disease:
The USPSTF recommends the use of aspirin for men age 45 to 79 years when the potential benefit
due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in
gastrointestinal hemorrhage.
The USPSTF recommends the use of aspirin for women age 55 to 79 years when the potential benefit
of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal
hemorrhage.
Screening for High Blood Pressure in Adults
The USPSTF recommends screening for high blood pressure in adults aged 18 and older.
AAA:
The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA)
by ultrasonography in men aged 65 to 75 who have ever smoked.
The USPSTF recommends against routine screening for AAA in women.
Screening for Coronary Heart Disease With Electrocardiography July 2012
The USPSTF recommends against screening with resting or exercise electrocardiography (ECG) for
the prediction of coronary heart disease (CHD) events in asymptomatic adults at low risk for CHD
events.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and
harms of screening with resting or exercise ECG for the prediction of CHD events in asymptomatic
adults at intermediate or high risk for CHD events.
Osteoporosis:
bone densitometry
The USPSTF recommends screening for osteoporosis in women aged 65 years or older and in
younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who
has no additional risk factors.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and
harms of screening for osteoporosis in men.
Barrett esophagus:
endoscopy
*only metaplasia= every 23 years
*low grade dysplasia= every 612 months
Screening for Asymptomatic Bacteriuria in Adults

The USPSTF recommends screening for asymptomatic bacteriuria with urine culture for pregnant
women at 12 to 16 weeks' gestation or at the first prenatal visit, if later.
Ovarian cancer September 2012
The USPSTF recommends against screening for ovarian cancer in women
Screening for Prostate Cancer May 2012
The USPSTF recommends against PSA-based screening for prostate cancer.
Behavioral Counseling to Prevent Skin Cancer May 2012
The USPSTF recommends counseling children, adolescents, and young adults aged 10 to 24 years
who have fair skin about minimizing their exposure to ultraviolet radiation to reduce risk for skin cancer.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and
harms of counseling adults older than age 24 years about minimizing risks to prevent skin cancer.
Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions October 2012
The USPSTF recommends against the use of combined estrogen and progestin for the prevention of
chronic conditions in postmenopausal women.
The USPSTF recommends against the use of estrogen for the prevention of chronic conditions in
postmenopausal women who have had a hysterectomy.
Screening for and Management of Obesity in Adults 2012
The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with
a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.

In September 2012, the U.S. Food and Drug Administration approved the first ultrasound
system, the somo-v Automated Breast Ultrasound System (ABUS), for breast cancer screening
specifically in women with dense breast tissue. ABUS is indicated as an adjunct to standard
mammography for women with a negative mammogram, no breast cancer symptoms and no
previous breast intervention such as surgery or biopsy.