Assessment of the Scientific Information for the Radiation Exposure Screening and Education Program (2005) / Chapter Skim
Currently Skimming:
Appendix E: Selected Cancer-Screening Recommendations
Appendix E: Selected Cancer-Screening Recommendations
Pages 371-386
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We have elected to present screening guidelines and recommendations only from the US Preventive Services Task Force (USPSTF) and the Canadian Task Force on Preventive Health Care (Canadian TF)
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372 APPENDIX E In the material that follows, we list cancers in alphabetical order; information from the USPSTF appears before that from the Canadian TF. For the USPSTF, the entries below come from the Web site of AHRQ, which supports the current USPSTF; the specific URLs are not listed here, but the general one is http:// www.ahrq.gov/clinic/cps3dix.htm#cancer (accessed May 4, 2004)
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APPENDIX E 373 "C. The USPSTF makes no recommendation for or against routine provi sion of [the service]
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374 APPENDIX E subgroups) with either an A or B rating (strongly recommends or recommends, respectively)
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APPENDIX E 375 whereas the likelihood of harms from screening (false-positive results and unnecessary anxiety, biopsies, and cost) diminish from ages 40-70.
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376 APPENDIX E Rating: A recommendation. Rationale: The USPSTF found good evidence from multiple observational studies that screening with cervical cytology (Pap smears)
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Rationale: The USPSTF found poor evidence to determine the benefits and potential harms of HPV screening as an adjunct or alternative to regular Pap smear screening. Trials are underway that should soon clarify the role of HPV testing in cervical cancer screening.
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There are insufficient data to determine which strategy is best in terms of the balance of benefits and potential harms or cost-effectiveness. Studies re viewed by the USPSTF indicate that colorectal cancer screening is likely to be cost-effective (less than $30,000 per additional year of life gained)
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380 APPENDIX E · Because most screening options are multiphasic, it is preferable that there is adequate infrastructure to support the implementation, assure quality con trol and the timely follow-up of screened individuals. Lung Cancer USPSTF The USPSTF concludes that the evidence is insufficient to recommend for or against screening asymptomatic persons for lung cancer with either low dose computerized tomography (LDCT)
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APPENDIX E 381 tion by physician and/or dentist should be considered for men and women over age 60 years with risk factors for oral cancers and precancers; indi vidual judgment should be exercised regarding the use of tolonium chloride for those identified as positive by oral physical exam. The above recommendation has been updated in 1999 · Population screening: Fair evidence to exclude screening the general population for oral cancer by clinical examination (D Recommendation)
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382 APPENDIX E of available screening tests, the invasive nature of diagnostic tests, and the poor outcomes of treatment. As a result, the USPSTF concluded that the harms of screening for pancreatic cancer exceed any potential benefits.
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APPENDIX E 383 patient. This is the view taken by the Canadian Task Force on the Periodic Health Examination.
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384 APPENDIX E for the early detection of cutaneous melanoma, basal cell cancer, or squa mous cell skin cancer. Rating: I recommendation.
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APPENDIX E 385 Currently, there is insufficient evidence to recommend for or against counsel ing patients to perform periodic self-examination of the skin. Clinicians may wish to educate patients with established risk factors for skin cancer (see above)
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Osteoporosis History, Risk assessment, Age 65 years; 60 years if high DEXA risk Syphilis infection VDRL, RDR, or TP-PA Persons at increased risk Pregnant Women Asymptomatic Urine culture bacteriuria Chlamydial infection Culture or Antibody or DNA tests Hepatitis B infection HBsAg test Rh incompatibility Rh (D) blood typing Syphilis infection VDRL, RDR, or TP-PA REFERENCES Canadian TF (Canadian Task Force on Preventive Health Care)
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