Health screening recommendations come from multiple sources. The US Preventive Services Task Force (USPSTF), the American Cancer Society, and individual professional societies issue guidelines. Although they are similar, they do not always agree. Each set of guidelines are determined by review of available literature with recommendations from an expert committee. The USPSTF guidelines will be discussed here.
The USPSTF expert committee is composed of sixteen volunteer members who represent disciplines of primary care including family medicine, internal medicine, nursing, obstetrics / gynecology, pediatrics, and behavioral medicine. They serve four year terms and are appointed by the Agency for Healthcare Research and Quality (AHRQ), a governmental agency. The mission of the agency is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Although the USPTF members are picked by the AHRQ, the task force is meant to provide independent un-biased recommendations.
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“The mission of the agency is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.”
Screening tests should fulfill five criteria. The condition screened should be an important heath problem, the condition should be treatable, there should be a significant incidence of the disease in the target population, the test should have high sensitivity and specificity, and the costs of treating the disease should be significant compared to the cost of the test.
The USPSTF grades evidence for or against screening for particular diseases as outlined in Table 1. An A grade means that there is good evidence of benefit and recommends screening. Grade B still recommends for screening but evidence is not as strong. Grade C recommends for screening in some cases while Grade D recommends against screening. Examples of a few recommendations are shown in Table 2. Please contact us if you have any questions about specific screenings.
Table 1
Table 2
