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Breast Cancer (Screening) Title Screening for Breast Cancer: Using Film Mammography Population Women aged 40-49 years Women aged 50-74 years Women aged ≥75 years Recommendation Individualize decision to begin biennial screening according to the patient’s circumstances and values. Grade: C Screen every 2 years. Grade: B No recommendation. Grade: I (Insufficient Evidence) Risk Assessment Screening Tests This recommendation applies to women aged ≥40 years who are not at increased risk by virtue of a known genetic mutation or history of chest radiation. Increasing age is the most important risk factor for most women. Standardization of film mammography has led to improved quality. Refer patients to facilities certified under the Mammography Quality Standards Act (MQSA), listed at http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMQSA/mqsa.cfm 16 Timing of Screening Evidence indicates that biennial screening is optimal. A biennial schedule preserves most of the benefit of annual screening and cuts the harms nearly in half. A longer interval may reduce the benefit. Balance of Benefits and Harms There is convincing evidence that screening with film mammography reduces breast cancer mortality, with a greater absolute reduction for women aged 50 to 74 years than for younger women. Harms of screening include psychological harms, additional medical visits, imaging, and biopsies in women without cancer, inconvenience due to false-positive screening results, harms of unnecessary treatment, and radiation exposure. Harms seem moderate for each age group. False-positive results are a greater concern for younger women; treatment of cancer that would not become clinically apparent during a woman’s life (overdiagnosis) is an increasing problem as women age. Rationale for No Recommendation (I Statement) Other Relevant USPSTF Recommendations Among women 75 years or older, evidence of benefit is lacking. USPSTF recommendations on screening for genetic susceptibility for breast cancer and chemoprevention of breast cancer are available at http://www.uspreventiveservicestaskforce.org. 1 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 clinical summary of 2002 Recommendation, see Appendix F. For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.
Breastfeeding Title Primary Care Interventions to Promote Breastfeeding Population Pregnant women New mothers The mother’s partner, other family members, and friends Infants and young children Recommendation Promote and support breastfeeding. Grade: B Benefits of Breastfeeding Mothers Less likelihood of breast and ovarian cancer Infants Fewer ear infections, lower-respiratorytract infections, and gastrointestinal infections Young children Less likelihood of asthma, type 2 diabetes, and obesity 17 Interventions to Promote Breastfeeding Interventions to promote and support breastfeeding have been found to increase the rates of initiation, duration, and exclusivity of breastfeeding. Consider multiple strategies, including: ●● ●● ●● ●● Formal breastfeeding education for mothers and families Direct support of mothers during breastfeeding Training of primary care staff about breastfeeding and techniques for breastfeeding support Peer support Interventions that include both prenatal and postnatal components may be most effective at increasing breastfeeding duration. In rare circumstances, for example for mothers with HIV and infants with galactosemia, breastfeeding is not recommended. Interventions to promote breastfeeding should empower individuals to make informed choices supported by the best available evidence. Implementation System-level interventions with senior leadership support may be more likely to be sustained over time. For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.
Page 1 and 2: The Guide to Clinical Preventive Se
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Page 7 and 8: Preface The U.S. Preventive Service
Page 9: Selector (ePSS), available via PDA,
Page 12 and 13: Hemochromatosis, Screening.........
Page 15: Preventive Services Recommended by
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Page 23 and 24: Abdominal Aortic Aneurysm Title Scr
Page 25 and 26: Aspirin for the Prevention of Cardi
Page 27 and 28: Bacterial Vaginosis in Pregnancy Ti
Page 29 and 30: Bladder Cancer Title Population Rec
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Page 39 and 40: Cognitive Impairment Title Populati
Page 41 and 42: Coronary Heart Disease (Risk Assess
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Page 45 and 46: Falls in Older Adults Title Populat
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Page 49 and 50: Glaucoma Title Population Recommend
Page 51 and 52: Healthful Diet and Physical Activit
Page 53 and 54: Hemochromatosis Title Population Re
Page 55 and 56: Hepatitis C Virus Infection Title S
Page 57 and 58: HIV Infection Title Population Reco
Page 59 and 60: Impaired Visual Acuity in Older Adu
Page 61 and 62: Lipid Disorders in Adults Title Scr
Page 63 and 64: Menopausal Hormone Therapy Title Me
Page 65 and 66: Obesity in Adults Title Population
Page 67 and 68: Osteoporosis Title Screening for Os
Page 69 and 70: Peripheral Artery Disease Title Pop
Page 71 and 72: Sexually Transmitted Infections Tit
Page 73 and 74: Skin Cancer (Screening) Title Scree
Page 75 and 76: Syphilis (Pregnant Women) Title Pop
Page 77 and 78: Tobacco Use in Adults Title Counsel
Page 79: Vitamin Supplementation to Prevent
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Blood Lead Levels in Children and P
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Congenital Hypothyroidism Title Scr
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Gonococcal Ophthalmia Neonatorum Ti
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High Blood Pressure (Children) Titl
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Illicit and Prescription Drug Use i
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Iron Deficiency Anemia (Supplementa
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Major Depressive Disorder in Childr
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Phenylketonuria (PKU) Title Populat
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Speech and Language Delay Title Pop
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Visual Impairment in Children Ages
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Immunizations for Adults and Childr
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Topics in Progress Each USPSTF reco
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Appendixes and Index
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Grade Definitions What the Grades M
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Grade Definitions Prior to May 2007
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David Grossman, M.D., M.P.H. Center
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Appendix C Acknowledgements AHRQ St
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Liaisons to the USPSTF Primary care
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The Task Force does not explicitly
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■■ ■■ Access the Electronic
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Appendix E More Resources AHRQ’s
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Healthy People 2020 Healthy People
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Index 2-hour postload plasma (see D
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Coronary Heart Disease (Risk Assess
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*Illicit and Prescription Drug Use
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Syphilis Infection (Pregnant Women)
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The U.S. Preventive Services Task F
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