Congress authorized the Agency for Healthcare Research and Quality (AHRQ) to start putting together the United States Preventative Services Task Force (USPSTF) in 1998. This task force is composed of medical experts and works to improve public health by recommending various preventative services. These recommendations have covered screenings, the use of preventative medications, and the identification of critical evidence gaps in research for further examination.
The task force grades these recommendations with the following grading system:
- Grade A. USPSTF recommends this service because there is a high certainty that the net benefit to the population is substantial.
- Grade B. The net benefit of the use of this recommendation is moderate to substantial.
- Grade C. At the population level, the balance of benefit to harm is close. The net value is small. The group explains that use of a recommendation with this grade is selective to patient values and circumstances.
- Grade D. The USPSTF recommends against the use of this preventative service because the risk of harm outweighs the benefits.
- I statement. This is used when the organization has insufficient evidence to assess the risk- to-benefit ratio. As such, it is not making a recommendation at the time of publication.
The medical professionals within this group choose a grade based on the strength of evidence, as well as a risk-to-benefit analysis of the preventative service with an A being the most reliable. The group releases a list of recommendations every year. This year, the USPSTS made the following recommendations:
#1: Give children fluoride drops if there is not enough in their drinking water
The USPSTF explained that when a local water supply does not contain equal to or more than 0.6 parts fluoride per million parts of water, it is insufficient to help prevent tooth decay in children. Since 23% of children from age 2 to 5 years suffer from tooth decay or dental cavities, known as dental caries, the group recommends primary care physicians prescribe fluoride drops for infants and children starting at 6 months of age. The group gave this recommendation a B rating.
#2: Screen pregnant women for gestational diabetes, healthy pregnancy weight gain, perinatal depression high blood pressure and urinary tract infections
The group recommended screening for gestational diabetes after the 24th week of pregnancy with a B rating, but gave screening prior to this date an I statement. The USPSTF also recommended physicians discuss healthy weight gain during pregnancy. The range varies depending on the mother’s weight. Those who are underweight before pregnancy can gain 28 to 40 pounds, if neither under nor overweight 25 to 35 pounds, if overweight 15 to 25 pounds, and if obese 11 to 20 pounds.
The USPSTF also reaffirmed a prior recommendation from 2014 to give pregnant women low-dose aspirin after 12 weeks of pregnancy if the woman is at high risk for preeclampsia with a B rating.
The USPTF recommends obtaining a urine culture between 12 and 16 weeks of gestation with an “A” recommendation. The American College of Obstetrics and Genecology (ACOG) recommends that a urine culture be obtained at the first prenatal visit, and a repeat urine culture should be obtained during the third trimester.
#3: Screen for chlamydia and gonorrhoea
The group recommended physicians screen for sexually transmitted infections (STI) chlamydia and gonorrhoea with a B rating for women over 25 years of age who are at increased risk of getting an STI. High risk factors can include having more than one sex partner, a sex partner who has other sex partners, or a failure to regularly use condoms.
#4: Screen overweight or obese adults for diabetes
In 2015 the USPSTF recommended screening overweight or obese adults ages 40 to 70 years for type 2 diabetes and prediabetes. The group has now lowered that age to 35 and encouraged referring those with prediabetes for additional preventative interventions. The group made this recommendation with a B rating.
#5: Change screening ages for colorectal and lung cancer
USPSTF also recommended lowering the age of screening for colorectal cancer to 45 years. It was previously set at 50 years. Screening for those 45 to 50 years has a B rating, 50 to 75 years of age receives an A rating and 76 to 85 a C.
The group also recommended reducing the threshold for testing for lung cancer from 55 and a 30-pack-year history to 50 and a 20 pack-year-history. Although they reaffirmed their recommendation to discuss tobacco use with patients and recommend cessation with an A rating, they gave discussion about cessation of electronic cigarettes an I statement.
The USPSTF issues guidelines about preventive screenings and tests for Primary Care Physicians so patients can benefit from early detection of diseases and cancers to prevent serious illness or death from these conditions.