Preventive Medicine

Heart Health

• Risk: HTN, HPL, DM, Tobacco, PVD, Obesity // Male, Age, Fam Hx of early CAD,
• Aspirin: Men age 40+, women age 50+; anyone, any age at high risk
• Framingham Risk

Health Risks

• Tobacco (former, current, never)/ Alcohol/ Obesity: BMI 18.5-25; waist: men<35inches, women < 32.5/ Sexual health: GC/CT/RPR/HIV

Breast Cancer Screen, age 40-75: Last Mammogram, clinical exam.

• Risk: Pers Hx Breast CA/BRCA/rad tx to chest/ atypical ductal/lobular hyperplasia/ Lobulular CIS/ FamHx

Cervical Cancer Screen: 21-30 (qyr), 30+ (Q2-3y, past 3+neg), 70+ (past 3+neg); consider GC/CT, HIV, Hep, RPR testing if new partner/ increased risk

• Risk: pers h/o cerv CA, high risk HPV, HIV, recent change in sexual partner, multiple sexual partners, STD, DES exposure

Colorectal Cancer Screen, age 50-80: Last Colonoscopy (q10y)/Colonography (q5y);

• Risk: Crohn’s/UC/pers h/o polyp/ca/strong fam hx

Prostate Cancer Screen, age 50-70: Last PSA, DRE

• Risk: PIN (pros intraepi neo)/ FamHx/AfAm

Lipid Screening, age 20-75: q5y

Osteoporosis Screening, postmenopausal: one-time

• Risk: smoking/ etOH/ hypogonadism(low estrogen in women, low testosterone in men)/ thin/ caucasion/ asian/ pers or fam hx of hip fx or osteoporosis/ diet deficient in Ca or Vit D/ fall risk/ steroids/ rheumatoid arthritis/ men 70+

AAA Screen, age 65-75 with any smoking history: one-time

• Risk: CAD/ CVD/ HTN/ HPL/ PVD

Skin Cancer

• Risk: personal or family history of basal cell, squamous cell, melanoma

Immunizations:

• Influenza, 50+
• Pneumovax, 65+; booster if 1^st vaccine at < 65yo and >5y ago; booster at 5y if inc risk
• Tetanus, q10y; if <65 yo and needs booster, use Adacel; Adacel booster if high risk and tetanus > 2y ago
• HPV, 9-26y
• Zoster, >65
• Other: consider varicella, hepatitis A, hepatitis B, and MMR

 To lower your risk of cancer from all causes:

• Stop smoking -- cigarette, pipe, cigar, tobacco chewing

• Decrease the amount of alcohol consumed

• Decrease the amount of dietary fat (especially saturated)

• Maintain a normal weight

• Decrease exposure to environmental carcinogens whenever possible (protect yourself when applying pesticides, herbicides, and related chemicals)

• Avoid sun exposure without sunscreen; use SPF 15 or greater

• Consider routine breast and testicular self-examination