Levels of Prevention and Preventive Screenings by Age, Sex, and Risk Factors

 

In the realm of healthcare, prevention is a cornerstone for maintaining optimal health and well-being. Prevention can be broadly categorized into three levels: primary, secondary, and tertiary. Each level plays a crucial role in safeguarding our health by addressing potential health issues at different stages—from preventing diseases before they occur to managing chronic conditions to avoid further complications.

However, the effectiveness of these preventive measures relies heavily on compliance with recommended screenings and interventions. Preventive screenings are essential tools in the early detection and management of diseases. They help identify health issues at an early stage when treatment is often more effective and less costly.

In this article, we will delve into the three levels of prevention, exploring the various strategies employed at each stage and their significance in the healthcare continuum. Additionally, we will highlight the critical importance of adhering to recommended preventive screenings. By understanding and complying with these recommendations, we can take proactive steps towards a healthier future, reduce the burden of disease, and improve overall quality of life. 

The three levels of prevention are: primary, secondary, and tertiary.

Primary Prevention: This level aims to prevent a disorder from occurring in the first place. Methods include:

• Vaccinations
• Counseling to modify high-risk behaviors
• Occasionally, chemoprevention

Secondary Prevention: This involves early detection and treatment of disease, often before symptoms arise, to reduce serious outcomes. Methods include:

• Screening programs (e.g., mammography for breast cancer, DXA for osteoporosis)
• Contact tracing and treatment for partners of individuals with sexually transmitted infections to control disease spread

Tertiary Prevention: This level focuses on managing chronic diseases to prevent complications or further damage. Methods include:

• For diabetes: Blood sugar control, good skin care, regular foot exams, and exercise to prevent cardiovascular issues
• For stroke survivors: Taking aspirin to prevent another stroke
• Providing rehabilitative services to prevent deterioration and enhance quality of life, such as rehab after injuries, heart attacks, or strokes
• Preventing complications in those with disabilities, such as avoiding pressure sores in bedridden patients.

In the United States, preventive screening tests are recommended based on age, sex, and risk factors. The following are common preventive screening tests recommended by health organizations such as the U.S. Preventive Services Task Force (USPSTF):

For Adults:

General Health:

• Blood Pressure Screening: Regular checks for hypertension, starting at age 18.
• Cholesterol Screening: Men aged 35 and older, and women aged 45 and older, or younger if at high risk for coronary heart disease.
• Diabetes Screening: Adults aged 35 to 70 who are overweight or obese, or earlier if at increased risk.
• Body Mass Index (BMI): Regular checks for overweight and obesity.

Cancer Screening:

• Colorectal Cancer: Screening for adults aged 45 to 75 using fecal occult blood testing, sigmoidoscopy, or colonoscopy.
• Breast Cancer: Mammography every 1-2 years for women aged 50 to 74, or earlier based on risk factors.
• Cervical Cancer: Pap smear every 3 years for women aged 21 to 65, or every 5 years with HPV testing for women aged 30 to 65.
• Lung Cancer: Annual screening with low-dose CT for adults aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
• Prostate Cancer: PSA-based screening for men aged 55 to 69 based on individual decision-making.

Bone Health:

• Osteoporosis: Bone density testing for women aged 65 and older, and younger women at increased risk.

Infectious Diseases:

• HIV Screening: Routine screening for adolescents and adults aged 15 to 65.
• Hepatitis C: One-time screening for adults aged 18 to 79.
• Sexually Transmitted Infections (STIs): Screening for chlamydia, gonorrhea, syphilis, and other STIs based on age and risk factors.

Other Screenings:

• Abdominal Aortic Aneurysm: One-time screening for men aged 65 to 75 who have ever smoked.
• Depression: Regular screening for all adults.
• Vision and Hearing: Periodic screening for older adults based on risk factors and symptoms.

For Children and Adolescents:

General Health:

• Newborn Screening: Blood tests for genetic, metabolic, and endocrine disorders.
• Growth and Development: Regular checks of growth and developmental milestones.
• Vision and Hearing: Screening at regular intervals.

Infectious Diseases:

• HIV Screening: For adolescents at increased risk.

Other Screenings:

• Lead Screening: For children at risk of exposure.

For Pregnant Women:

• Blood Pressure Screening: At each prenatal visit.
• Gestational Diabetes: Screening at 24 to 28 weeks of gestation.
• Hepatitis B: Screening at the first prenatal visit.
• HIV Screening: At the first prenatal visit.
• Syphilis Screening: At the first prenatal visit.
• Rh(D) Incompatibility: Blood typing and antibody testing for Rh(D) negative women.

These recommendations may vary based on individual health conditions and risk factors, so it is important to consult healthcare providers for personalized screening schedules. 

 Whether you are seeking to prevent illness, detect issues early, or manage an existing condition, knowledge and action are your best allies in maintaining good health.

 

Source:

 Tools of Prevention - Fundamentals - Merck Manual Consumer Version (merckmanuals.com)

Recommendation Topics | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org)