Friday, October 23, 2015

Preventive care: what's new in the past 7 years

While studying for my 2009 American Family Medicine board exams I wrote up a summary of the American Academy of Family Practice’s preventive care recommendations. For this November’s exam I updated my old notes, so I got to see what’s changed with preventive care over the past 7 years.

There are more listings now, but most of the additions are recommendations not to do anything. HPV and cervical cancer screening recommendations still don’t consider immunization status. Screening for diabetes in pregnancy was removed in 2008 (though everyone would still do it) but it’s back in 2015. Hep C screening is recommended for at risk or born 1945-65; that’s because we have decent treatments now. I was a bit surprised that HIV screening is now recommended for everyone age 18-65 — though the screening interval is murky. Screening used to be limited to higher risk populations.

Lung cancer went from “don’t screen” to equivocal, but PSA (prostate specific antigen) went from equivocal to “don’t screen” (remember when every senior guy needed that?).

And … that’s about it. Based on the news this week mammogram screening will be further reduced but that’s not part of the official recommendations yet.

Not a lot of change.

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