Over the past quarter century, prevention has become a major activity in primary care. During a typical day, primary care clinicians spend much of their time managing asymptomatic conditions in which the main goal is to prevent death or complications (e.g., hypertension, hyperlipidemia, osteoporosis). This chapter focuses primarily on preventive screening recommendations from the United States Preventive Services Task Force (USPSTF). The rationale and evolution of preventive care guidelines are discussed. Advantages and disadvantages of cervical, colorectal, breast, prostate, ovarian and lung cancer screening are explained, along with recommendations regarding behavioral counseling, especially for smoking cessation and alcohol use. Graphs are included. Tables delineate major causes of death in the United States, criteria for evaluating a screening program, sample board examination questions about screening, government-sponsored preventive guidelines programs, the USPSTF grading system, strongly recommended noncancer preventive services in adults, the recommended adult immunization schedule, recommended and strongly recommended measures for cancer prevention, recommended preventive noncancer screening measures, and selected recommendations for counseling and patient education.
This review contains 5 figures, 10 tables, and 77 references.
There are no randomized controlled trials that support the United States Preventive Services Task Force guideline on screening for depression in primary care: a systematic review