Adult Preventive Services Recommendations Guidelines Definitions

 

  These are average risk recommendations based on the USPSTF, ICSI, ACS, and other recommendations and, in particular, the Mayo Model of Care.

  Some of the factors that increase risk for patients are listed so providers can potentially modify screening or early detection testing based on individual patient risk factor profile, in addition to considering subspecialty referral.

  These guidelines are for asymptomatic patients.  Patients with symptoms should be investigated as appropriate.

  Strong family history is defined as one or more first degree relatives with the condition in question, unless otherwise specified (see lipid screening guidelines).

  Screening could be considered beyond the upper age limit if life expectancy is greater than 10 years.

 

Breast Cancer Screening:

 

  Personal history of breast cancer

  Personal or family history of BRCA1 and BRCA2 mutations

  >20% lifetime risk

  Radiation to chest ages 10-30

  Atypical ductal hyperplasia

  Atypical lobular hyperplasia

  Lobular carcinoma in situ

  Gail Model 5-year risk > 1.66%

  Strong family history

 

Cervical Cancer Screening:

 

  History of cervical cancer

  Infection with high-risk HPV type

  HIV infection

  Recent change in sexual partner

  Multiple sexual partners

  History of sexually transmitted disease

  Diethylstilbesterol (DES) exposure in utero

 

Colorectal Cancer Screening:

 

  Crohns disease

  Ulcerative colitis

  Personal history of either adenomatous polyp or colon cancer

  Strong family history

 

Prostate Cancer Screening:

 

  PIN (prostatic intraepithelial neoplasia)

  Strong family history

  African American race

 

Tobacco Use:

 

 

Lipid Screening:

 

  Family or personal history of CAD, stroke, diabetes mellitus, prior lipid abnormality

v  For coronary artery disease (CAD), family history is defined as first degree male relative with CAD <55 years or first degree female with CAD <65 years

 

Osteoporosis Screening:

 

  Smoking

  Excessive alcohol intake (more than 2 drinks per day)

  Hypogonadism (estrogen deficiency in women or testosterone deficiency in men)

  Thin body habitus (weight <55 kg or BMI <29 kg/m2)

  Caucasian or Asian race

  Personal or family history of hip fracture or osteoporosis

  Diet deficient in calcium or vitamin D without adequate supplementation

  Increased likelihood of falling

  Long-term treatment of glucocorticoid hormones

  Rheumatoid arthritis

  Men over 70 years

 

Abdominal Aortic Aneurysm Screening:

 

  Family history

  Coronary artery disease

  Cerebrovascular disease

  Hypertension

  Hypercholesterolemia

  Claudication

 

Immunizations:

 

  Influenza vaccine every year for all adult patients with chronic lung or heart disease, diabetes mellitus, chronic alcoholism, cirrhosis, HIV infection, multiple myeloma, chronic prednisone use, organ transplantation, hemoglobinopathies, chronic tobacco abuse, renal disease, and health care workers.

  Patients with chronic lung or heart disease, diabetes mellitus, chronic alcoholism, CSF leak, asplenia, renal disease, chronic tobacco abuse, cirrhosis, HIV infection, multiple myeloma, chronic prednisone use, and organ transplantation should receive Pneumococcal vaccine at an earlier age.

  Adults who have contact with infants, such as health care workers, parents, or child care providers, or any woman planning to become pregnant, should receive a Tdap vaccination if their most recent tetanus booster was more than 2 years ago.

 

Other Adult Immunizations:

 

 

http://mayoweb.mayo,edu/nurs-ambulatory/immunizations-adult.html

 

or CDC website at:

 

http://www.cdc.gov/nip/menus/vaccines.htm#Schedules