The USPSTF was commissioned in 1984 as a 20-member nongovernmental panel of experts in primary care medicine, epidemiology, and public health. The USPSTF, comprising primary care providers, now includes nonfederal experts in prevention and evidence-based medicine (such as internists, pediatricians, family physicians, gynecologists-obstetricians, nurses, and health behavior specialists); the task force conducts and publishes scientific evidence reviews on a variety of preventive health services with administrative and research support from the AHRQ. Initial and subsequent reviews and recommendations are being revised and periodically released on the Web site sponsored by the AHRQ (15). The charge to the panel was to develop recommendations for the appropriate use of preventive interventions based on a systematic review of evidence of clinical effectiveness. The panel was asked to rigorously evaluate clinical research to assess the merits of preventive measures, including screening tests, counseling, immunizations, and medications.
Table 8.2 Periodic Assessment Ages 19–39 Years
Health status: medical, surgical, family Tuberculosis skin testing
Use of complementary and alternative medicine Contraceptive options for prevention of unwanted pregnancy, including emergency contraception
Tobacco, alcohol, other drug use Discussion of a reproductive health plan§
Blood pressure Exercise: discussion of program
Neck: adenopathy, thyroid Dietary/nutrition assessment
Pelvic examination: for ages 19–20 years, when indicated by the Psychosocial Evaluation medical history; age 21 or older, periodic pelvic examination
Cervical cytology†: Work satisfaction
Age 21 years: screen every 2 years Lifestyle/stress
Age 30 years or older: Sleep disorders
Option 1: may screen every 3 years after three consecutive Cardiovascular Risk Factors negative test results with no history of cervical intraepithelial neoplasia 2 or 3, immunosuppression, human immunodeficiency virus (HIV) infection, or diethylstilbestrol exposure in utero; or
Option 2: screen every 3 years after negative human Family history papillomavirus DNA test and negative cervical cytology
Table 8.2 (Continued ) —Safety belts and helmets Leading Causes of Death**
Skin exposure to ultraviolet rays 1. Malignant neoplasms
Suicide: depressive symptoms 2. Accidents (unintentional injuries)
Tobacco, alcohol, other drug use 3. Diseases of the heart
Immunizations 4. Intentional self harm (suicide)
Periodic 5. Human immunodeficiency virus (HIV) disease
Diphtheria and reduced tetanus toxoids and acellular 6. Assault (homicide) pertussis vaccine (substitute one-time dose of Tdap for Td booster; then boost with Td every 10 years)#
Human papillomavirus vaccine (one series for those aged 7. Cerebrovascular diseases 26 years or less and not previously immunized)
Varicella vaccine (one series for those without evidence of 8. Diabetes mellitus immunity)
High-Risk Groups* 9. Chronic liver diseases and cirrhosis
Hepatitis A vaccine (consider combination vaccine for those 10. Chronic lower respiratory diseases at risk far hepatitis A and B) *See Table 8.5.
†For a more detailed discussion of cervical cytology screening, including the use of human papillomavirus DNA testing and screening after hysterectomy, see Cervical cytology screening. ACOG Practice Bulletin No. 109. American College of Obstetricians and Gynecologists. Obstet Gynecol 2009:114: 1409–20.