Health screenings help healthy people stay well. Physicians use them to look for signs of potential problems before they become symptomatic and when they’re easier to treat. A multitude of health-care organizations develop screening guidelines, but they don’t always agree. That’s where the United States Preventive Services Task Force steps in. This independent, non-governmental body digs deep into the research to compare the benefits and harms of a wide variety of preventive screenings. Here’s a look at the Task Force’s recommended screenings:
- Abdominal aortic aneurysm. The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men ages 65 to 75 years with a history of smoking. Men in this age group who have never smoked may be screened selectively taking into consideration a patient’s medical history, family history, other risk factors and personal values. There is insufficient evidence to assess the balance of benefits and harms of screening for AAA with ultrasonography in women ages 65 to 75 years who have ever smoked or have a family history of AAA. Women who have never smoked should not be screened.
- Breast cancer. Women should have a mammogram every other year starting by age 50. Some women in their 40s may benefit from screening and should discuss what’s best for them with their doctor. The current evidence is insufficient to assess the balance of benefits and harms of mammography in women ages 75 years or older.
- Cervical cancer. Screening is recommended every three years with the Pap test (cervical cytology) for women ages 21 to 29. Women ages 30 to 65 have three options: screening with the Pap test alone every three years, screening with high-risk human papillomavirus (hrHPV) testing alone every five years, or with both tests every five years.
Cervical cancer screening is not recommended in women who are older than age 65 who have had adequate prior screening and are not otherwise at high risk, or for women of any age who have had a hysterectomy with removal of the cervix and no history of cervical cancer or no history of high-grade precancerous lesions.
- Colorectal cancer. Screening should begin at age 45 and continue until age 75. The frequency of screening depends on the test used. Stool based tests should be repeated every one to three years (depending on the specific stool test used), whereas CT colonography (the use of CT scanning to produce images of the colon) and flexible sigmoidoscopy (an endoscopic examination of the rectum and lower colon) are recommended every five years. Flexible sigmoidoscopy can occur every 10 years if stool testing with a fecal immunochemical test (FIT) occurs every year. Colonoscopy, which lets your doctor see the entire colon, should be repeated every 10 years.
The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults ages 76 to 85.
- Hepatitis B. Screening is recommended for people at increased risk, including those born in countries with a high prevalence of hepatitis B, unvaccinated people born in the United States to parents from a high-risk country, current or previous users of injected drugs, men who have sex with men, people with HIV, and those with household contacts or sexual partners of hepatitis-B-positive people.
- Hepatitis C. Screening should be done at least one time for adults ages 18 to 79. People who continue to have risk factors, such as injected drug use, should be routinely tested.
- Human immunodeficiency virus. Screening should occur in everyone ages 15 to 65. Adults older than 65 should be screened if they have risk factors for HIV. Risk factors include sexually active men who have sex with men, people with an HIV-positive sex partner, injectable drug use, commercial sex work, and having other sexually transmitted infections.
- Hypertension. The USPSTF recommends screening blood pressure in a clinician’s office for people ages 18 or older who do not have known hypertension.
- Lung cancer. Screening with lowdose computed tomography (a procedure that uses a computer linked to an x-ray machine that gives off a very low dose of radiation to make a series of detailed images) is recommended for adults ages 50 to 80 years who have smoked the equivalent of a pack of cigarettes a day for 20 years and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years.
- Osteoporosis. Bone measurement testing is recommended in all women ages 65 and older, and in postmenopausal women who are younger than 65 but are at risk based on a formal risk assessment. Risk factors include a parental history of hip fracture, smoking, excessive alcohol consumption and low body weight. It’s unclear how often this testing should occur, but limited evidence suggests that re-testing women with normal bone mass in four to eight years offers no additional benefit.
- Prostate cancer. Men ages 55 to 69 should talk with their physicians about undergoing periodic PSA-based screening for prostate cancer. Patients should consider family history, race and ethnicity, and other medical conditions to determine if screening is appropriate. Men 70 and older should not be screened for prostate cancer.
- Type 2 diabetes. People ages 35 to 70 who have a BMI of 25 and over should be screened for prediabetes and type 2 diabetes.
