Age-Based Preventive Care Screening (USPSTF Grade A/B)

Algorithm Steps

1. ▶

   Start

   Preventive Care Assessment

   USPSTF Grade A & B Recommendations

   1. ◆

      Decision

      Age Group

      Determine applicable screenings

      1. ●

         Action

         All Adults

         Universal screenings

         • Blood pressure: All adults, annually
         • Depression: All adults (PHQ-2/9)
         • Unhealthy alcohol use: All adults (AUDIT-C)
         • HIV: Ages 15-65 at least once
         • Hepatitis C: Ages 18-79 once
         • Tobacco use: Ask all, offer cessation
         1. ●

            Action

            Adult Immunizations

            ACIP recommendations (not USPSTF)

            • Influenza: Annually all adults
            • Tdap/Td: Once Tdap, Td every 10 years
            • Shingrix: 50+ (2 doses)
            • Pneumococcal: 65+ (PCV20 or PCV15+PPSV23)
            • COVID-19: Per current guidance
            • HPV: Through age 26
            1. ●

               Action

               Behavioral Counseling

               USPSTF-recommended interventions

               • Healthy diet/physical activity (CVD risk)
               • Falls prevention (65+)
               • Skin cancer prevention (sun exposure)
               • STI prevention (sexually active)
               • Tobacco cessation interventions
      2. ●

         Action

         Ages 40-75

         Cardiovascular and metabolic

         • Lipid panel for CV risk (40-75)
         • Diabetes (prediabetes if overweight 35-70)
         • Statin therapy (per ASCVD risk)
         • Abdominal aortic aneurysm (men 65-75 who smoked): Once
      3. ●

         Action

         Cancer Screenings

         By age and sex

         • Breast (women 50-74): Mammogram every 2 years
         • Cervical (women 21-65): Pap q3yr or cotesting q5yr (30-65)
         • Colorectal (45-75): Colonoscopy q10yr, FIT annually, or alternatives
         • Lung (50-80, 20+ pack-year): Low-dose CT annually
         1. ●

            Action

            Breast Cancer Screening

            Women 50-74

            • Mammography every 2 years
            • Ages 40-49: Individual decision
            • BRCA testing if family history suggests hereditary syndrome
            • Chemoprevention discussion if ≥3% 5-year risk
         2. ●

            Action

            Colorectal Cancer Screening

            Ages 45-75

            • Colonoscopy every 10 years
            • FIT (fecal immunochemical) annually
            • FIT-DNA (Cologuard) every 1-3 years
            • Flexible sigmoidoscopy every 5 years
            • Stop at 75 (individual decision 76-85)
         3. ●

            Action

            Lung Cancer Screening

            High-risk smokers

            • Low-dose CT annually
            • Ages 50-80
            • ≥20 pack-year smoking history
            • Currently smoke or quit within 15 years
            • Shared decision-making required
      4. ●

         Action

         Women-Specific

         Reproductive and perinatal

         • Intimate partner violence: All women
         • Folic acid (planning pregnancy)
         • Gestational diabetes (24-28 weeks)
         • Rh(D) incompatibility screening
         • Preeclampsia: Low-dose aspirin if high risk