Screening Elements

Frequency

Evidence based CLINICAL STRATEGY / NOTES

Female
60+

LIFE STYLES/BEHAVIOURAL

Weight

Every 2 years

Every 12 months and Periodically, 18 years and older for risk group (diabetes and CVD etc)

(S) Smoking

Every 12 months

Every 6 months for risk group, mental illness, chemical dependency

(N) Nutrition

Every 2 years

Every 6 months for overweight, obese, high CV AR (>15%), family history CVD <60 years, type 2 diabetes

(A) Alcohol – early detection of problem drinking

Every 3 years
Opportunistically

Every 12 months for high BP, liver disease, major organ damage, pre/pregnancy, history of mental health problem, drug taking

(P) Physical activity

Every 12 months

Every visit teenage girls, chronic disease or CVD

IMMUNIZATION

Refer to Protocol

Tetanus-Diptheria (Td)

Refer to Protocol

Every 10 Years, 18 years and older

Refer to Protocol

Varicella (VZV)

Refer to Protocol

Susceptible only —Two doses at 18 years and older

Refer to Protocol

Pneumococcal

One dose

One dose, 65 years and older and for high risk group

Influenza

Every 1 year

Yearly, 50 years and older

Hepatitis B

For high risk group

COMMUNICABLE DISEASES / SEXUALLY TRANSMITTED INFECTIONS (STIs)

Pulmonary Tuberculosis

Tuberculin skin testing is recommended for asymptomatic high-risk persons, students (universities demands)

PREVENTIVE VASCULAR DISEASES

Blood pressure

Every 2 years

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.

Hemoglobin / Hematocrit

Opportunistically

Pregnant women

Type 2 diabetes

Every 3 years

Every 12 months with IGT/IFG, and Periodically adults with hypertension or hyperlipidemia. From 10 yrs if at risk and obese.

(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

PSYCHOSOCIAL/MENTAL

Depression / Stress

Opportunistically

At every encounter – every 2 years with high risk

CANCER

Skin cancer

Every 12 months

From 13 years for those at high risk

Cervical cancer
(Pap Smear)

Every 1-3 years

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.

Breast cancer (Mammography)

Every 2 years

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.

Colorectal cancer
Occult blood

Every 1-2 years

Periodically, 50 years and older, Earlier for high risk

Colorectal cancer
Flexible sigmoidoscopy

Every 5 - 10 years

Periodically, 50 years and older, Earlier for high risk

CHEMOPREVENTION

Aspirin (CVS Risk Ass.)

Periodically – Men 40 yrs & older. Women 50 yrs & older

Calcium

Women, Periodically, 18 years and older

Vitamin D

Women, Periodically, 18 years and older

ELDERLY

Visual Impairment

Every 5 years

All people aged 50 – 64 years; every 5 yrs. Every year after 65

Hearing Impairment

Every 12 months

Recommendations against screening, except for those exposed to excessive occupational noise levels. Every 12 months 65+ years

Falls risk

Every 12 months

Every 6 months with history of 1 or more falls or multiple risk factors

Osteoporosis (BMD)

Women, routinely, > 65 yrs or > 60 yrs at increased risk for fractures.

Polypharmacy

Opportunistically

With risk factors for medication related problems. Taking > five regular medications or taking > 12 doses per day, or significant changes in medication regimen during the past 3 months.

OTHER TESTS

Stool exam R&M

Every 1 year

Food handlers