Doug Campos-Outcalt, MD, MPA Department of Family and Community Medicine, University of Arizona College of Medicine, Phoenix dougco@u.arizona.edu
Latest recommendations from the USPSTF reinforce some long-standing advisories and contradict others.
TABLE 4 Evidence is INSUFFICIENT to recommend for or against
Aspirin for cardiovascular disease prevention in men and women ≥80 years of age.
Computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer.
Screening children 7 to 11 years of age for major depressive disorders.
Screening for type 2 diabetes in asymptomatic adults with blood pressure ≤135/80 mm Hg.
Screening adolescents, adults, and pregnant women for illicit drug use.
Routine screening for gestational diabetes.
Prostate cancer screening in men <75 years of age.
Behavioral counseling to prevent sexually transmitted infections (STIs) in nonsexually active adolescents and in adults not at increased risk for STIs.
Whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the general adult population.
What’s the take-home message?
All of these recent Task Force decisions add substantially to the full set of Task Force recommendations, which can be found at www.ahrq.gov/CLINIC/uspstfix.htm. Given the large number of level A and B recommendations from the Task Force, clinicians are faced with the dilemma of limited time to accomplish all the recommendations. It is reasonable to concentrate on the positive recommendations and avoid performing the interventions recommended against. The interventions in the “I” category are not as clear-cut and clinicians will continue to struggle with them, particularly when other professional organizations recommend them.
CORRESPONDENCE Doug Campos-Outcalt, MD, MPA, 550 E. Van Buren, Phoenix, AZ 85004; dougco@u.arizona.edu.
