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Screening Elements
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Frequency
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Evidence based CLINICAL STRATEGY / NOTES
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Female
40 – 60
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LIFE STYLES/BEHAVIOURAL
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Weight
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Every 2 years
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Every 12 months and Periodically, 18 years and older for risk group (diabetes and CVD etc)
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(S) Smoking
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Every 12 months
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Every 6 months for risk group, mental illness, chemical dependency
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(N) Nutrition
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Every 2 years
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Every 6 months for overweight, obese, high CV AR (>15%), family history CVD <60 years, type 2 diabetes
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(A) Alcohol – early detection of problem drinking
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Every 3 years
Opportunistically
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Every 12 months for high BP, liver disease, major organ damage, pre/pregnancy, history of mental health problem, drug taking
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(P) Physical activity
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Every 12 months
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Every visit teenage girls, chronic disease or CVD
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IMMUNIZATION
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Refer to Protocol
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|
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Tetanus-Diptheria (Td)
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Refer to Protocol
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Every 10 Years, 18 years and older
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Refer to Protocol
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Varicella (VZV)
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Refer to Protocol
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Susceptible only —Two doses at 18 years and older
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Refer to Protocol
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Measles, Mumps, Rubella
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Refer to Protocol
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Women of childbearing age — One dose (18-50 years)
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Refer to Protocol
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Rubella
|
|
Childbearing age at their first clinical encounter
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Pneumococcal
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One dose
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One dose, 65 years and older and for high risk group
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Influenza
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Every 1 year
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Yearly, 50 years and older
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Hepatitis B
|
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For high risk group
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COMMUNICABLE DISEASES / SEXUALLY TRANSMITTED INFECTIONS (STIs)
|
|
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Chlamydia
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Opportunistically
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18-25 yrs for sexually active women. Every 1 yr for those at high risk
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Syphilis Infection (VDRL)
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Opportunistically
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Persons at increased risk for syphilis and all pregnant women
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Pulmonary Tuberculosis
|
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Tuberculin skin testing is recommended for asymptomatic high-risk persons, students (universities demands)
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PREVENTIVE VASCULAR DISEASES
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|
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Blood pressure
|
Every 2 years
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Every 2 years for persons with SBP and DBP below 130 mm Hg and 85 mm Hg. Every 12 months with lifestyle risk factors. Every 6 months for high risk and opportunistically otherwise.
|
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Hemoglobin / Hematocrit
|
Opportunistically
|
Pregnant women
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Type 2 diabetes
|
Every 3 years
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Every 12 months with IGT/IFG, and Periodically adults with hypertension or hyperlipidemia. From 10 yrs if at risk and obese.
|
|
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(Lipid profile)
- Total Cholesterol
- HDL
|
Every 5 years
|
Every 5 years for men 35 years and older & women 45 years & older. And for men aged 20 to 35 years & women aged 20 to 45 years if they have other risk factors for CVD. Every 1–2 years 45+ years with risk factors and family history premature CVD.
Every 12 months with increased CV risk & existing diagnoses
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PSYCHOSOCIAL/MENTAL
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|
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Depression / Stress
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Opportunistically
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At every encounter – every 2 years with high risk
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CANCER
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|
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Skin cancer
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Every 12 months
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From 13 years for those at high risk
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Cervical cancer
(Pap Smear)
|
Every 1-3 years
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Repeat at 1 to 3 Years, 18 - 70 years. Or after 3 yrs of marriage, yearly for 3 consecutive years, if negative every 3 years.
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Breast cancer (Mammography)
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Every 2 years
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Start at < 40 yrs for high risk. Every 1 to 2 Years, 40 years and older. Mammography with or without clinical breast examination, every 1–2 years for women 40 years of age and older.
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Colorectal cancer
Occult blood
|
Every 1-2 years
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Periodically, 50 years and older, Earlier for high risk
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Colorectal cancer
Flexible sigmoidoscopy
|
Every 5 - 10 years
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Periodically, 50 years and older, Earlier for high risk
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CHEMOPREVENTION
|
|
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Aspirin (CVS Risk Ass.)
|
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Periodically – Men 40 yrs & older. Women 50 yrs & older
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Calcium
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Women, Periodically, 18 years and older
|
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Vitamin D
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Women, Periodically, 18 years and older
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Folic Acid
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Women of childbearing age, 18-50 years
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ELDERLY
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Visual Impairment
|
Every 5 years
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All people aged 50 – 64 years; every 5 yrs. Every year after 65
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Hearing Impairment
|
Every 12 months
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Recommendations against screening, except for those exposed to excessive occupational noise levels. Every 12 months 65+ years
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Osteoporosis (BMD)
|
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Women, routinely, > 65 yrs or > 60 yrs at increased risk for fractures.
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OTHER TESTS
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ABO Grouping and Rh (D)
Incompatibility
|
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Perform Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy. Repeated Rh (D) antibody testing for all unsensitized Rh (D) negative women at 24 and 28 weeks’ gestation, unless the biological father is known to be Rh (D) negative.
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Stool exam R&M
|
Every 1 year
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Food handlers
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