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Healthy People 2020 Healthy People 2020 is an initiative from the U.S. Department of Health and Human Services that challenges individuals, communities, and professionals to take specific steps to ensure good health. Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. Read more at www.healthypeople.gov/2020/ default.aspx. National Guideline Clearinghouse TM A public resource for evidence-based clinical practice guidelines, NGC (guideline.gov/index.aspx) was originally created by AHRQ in partnerships with the American Medical Association and the American Association of Health Plans (now America’s Health Insurance Plans). The NGC mission is to provide physicians and other health professionals, health care providers, health plans, integrated delivery systems, purchasers, and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use of this information. Canadian Task Force on Preventive Health Care The Task Force was established by the Public Health Agency of Canada to develop clinical practice guidelines that support primary care providers in delivering preventive health care. The mandate of the Task Force is to develop and disseminate clinical practice guidelines for primary and preventive care, based on systematic analysis of scientific evidence. Read more at www.canadiantaskforce.ca/. Cancer Control P.L.A.N.E.T. A service of the National Cancer Institute, the Cancer Control P.L.A.N.E.T. portal provides access to Web-based resources that can help planners, program staff, and researchers to design, implement, and evaluate evidence-based cancer control programs. Read more at cancercontrolplanet.cancer.gov/index.html. HealthCare.gov This Web site (www.healthcare.gov), managed by the U.S. Department of Health and Human Services, helps people take health care into their own hands. It provides information about insurance options, using insurance, the Affordable Care Act, comparing providers, and prevention and wellness—including which preventive services are covered under the Act. 114
Breast Cancer (2002 Recommendation)* Title Population Screening for Breast Cancer (2002 Recommendation) Women ages 40 years and older Screening Test Mammography, with or without clinical breast examination Clinical breast examination alone Breast self-examination alone Recommendation Screen every 1 to 2 years. Grade: B No recommendation. Grade: I (Insufficient Evidence) No recommendation. Grade: I (Insufficient Evidence) 115 Risk Assessment Screening Tests Balance of Benefits and Harms Women who are at increased risk for breast cancer (e.g., those with a family history of breast cancer in a mother or sister, a previous breast biopsy revealing atypical hyperplasia, or first childbirth after age 30) are more likely to benefit from regular mammography than women at lower risk. There is fair evidence that mammography screening every 12 to 33 months significantly reduces mortality from breast cancer. Evidence is strongest for women ages 50 to 69 years. For women ages 40 to 49 years, the evidence that screening mammography reduces mortality from breast cancer is weaker, and the absolute benefit of mammography is smaller, than it is for older women. Clinicians should refer patients to mammography screening centers with proper accreditation and quality assurance standards to ensure accurate imaging and radiographic interpretation. Clinicians should adopt office systems to ensure timely and adequate follow-up of abnormal results. The precise age at which the benefits from screening mammography justify the potential harms is a subjective judgment and should take into account patient preferences. Clinicians should inform women about the potential benefits (reduced chance of dying from breast cancer), potential harms (false-positive results, unnecessary biopsies), and limitations of the test that apply to women their age. The balance of benefits and potential harms of mammography improves with increasing age for women ages 40 to 70 years. Appendix F Clinicians who advise women to perform breast self-examination or who perform routine clinical breast examination to screen for breast cancer should understand that there is currently insufficient evidence to determine whether these practices affect breast cancer mortality, and that they are likely to increase the incidence of clinical assessments and biopsies. Other Relevant USPSTF Recommendations The USPSTF has made recommendations on screening for genetic susceptibility for breast cancer and chemoprevention of breast cancer. These recommendations are available at http://www.uspreventiveservicestaskforce.org/. *The U.S. Department of Health and Human Services, in implementing the Affordable Care Act, under the standard it sets out in revised Section 2713(a)(5) of the Public Health Service Act, utilizes the 2002 recommendation on breast cancer screening of the U.S. Preventive Services Task Force. For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org/.
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The Guide to Clinical Preventive Se
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The Guide to Clinical Preventive Se
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Preface The U.S. Preventive Service
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Selector (ePSS), available via PDA,
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Hemochromatosis, Screening.........
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Preventive Services Recommended by
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Section 1: Preventive Services Reco
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4 13 Asymptomatic adults with susta
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Abdominal Aortic Aneurysm Title Scr
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Aspirin for the Prevention of Cardi
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Bacterial Vaginosis in Pregnancy Ti
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Bladder Cancer Title Population Rec
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Breast Cancer (Preventive Medicatio
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Breastfeeding Title Primary Care In
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Cervical Cancer Title Screening for
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Chronic Kidney Disease Title Popula
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Cognitive Impairment Title Populati
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Coronary Heart Disease (Risk Assess
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Depression in Adults Title Populati
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Falls in Older Adults Title Populat
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Genital Herpes Time Screening for G
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Glaucoma Title Population Recommend
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Healthful Diet and Physical Activit
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Hemochromatosis Title Population Re
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Hepatitis C Virus Infection Title S
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HIV Infection Title Population Reco
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Impaired Visual Acuity in Older Adu
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Lipid Disorders in Adults Title Scr
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Menopausal Hormone Therapy Title Me
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Obesity in Adults Title Population
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Osteoporosis Title Screening for Os
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Peripheral Artery Disease Title Pop
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Sexually Transmitted Infections Tit
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Skin Cancer (Screening) Title Scree
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Syphilis (Pregnant Women) Title Pop
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Tobacco Use in Adults Title Counsel
Page 79: Vitamin Supplementation to Prevent
Page 83 and 84: Blood Lead Levels in Children and P
Page 85 and 86: Congenital Hypothyroidism Title Scr
Page 87 and 88: Gonococcal Ophthalmia Neonatorum Ti
Page 89 and 90: High Blood Pressure (Children) Titl
Page 91 and 92: Illicit and Prescription Drug Use i
Page 93 and 94: Iron Deficiency Anemia (Supplementa
Page 95 and 96: Major Depressive Disorder in Childr
Page 97 and 98: Phenylketonuria (PKU) Title Populat
Page 99 and 100: Speech and Language Delay Title Pop
Page 101: Visual Impairment in Children Ages
Page 105: Immunizations for Adults and Childr
Page 109 and 110: Topics in Progress Each USPSTF reco
Page 111: Appendixes and Index
Page 114 and 115: Grade Definitions What the Grades M
Page 116 and 117: Grade Definitions Prior to May 2007
Page 118 and 119: David Grossman, M.D., M.P.H. Center
Page 120 and 121: Appendix C Acknowledgements AHRQ St
Page 122 and 123: Liaisons to the USPSTF Primary care
Page 124 and 125: The Task Force does not explicitly
Page 126 and 127: ■■ ■■ Access the Electronic
Page 128 and 129: Appendix E More Resources AHRQ’s
Page 133 and 134: Index 2-hour postload plasma (see D
Page 135 and 136: Coronary Heart Disease (Risk Assess
Page 137 and 138: *Illicit and Prescription Drug Use
Page 139: Syphilis Infection (Pregnant Women)
Page 143 and 144: The U.S. Preventive Services Task F
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