A 50-year-old man comes to the clinic to establish care. He has not been evaluated by a healthcare provider in 15 years and has not received any routine medical care or screenings during this time. He generally feels well and takes no medications. He smokes 1 pack of cigarettes daily for the past 30 years and drinks 2 to 3 alcoholic beverages on weekends. He is sexually active with men and uses condoms inconsistently. His BMI is 25 kg/m². Vital signs are within normal limits. Physical examination reveals no abnormalities.
Which of the following preventive interventions are indicated for this patient at this visit? (Select all that apply)
- Annual low-dose computed tomography of the chestAnswer
- Screening colonoscopyAnswer
- CScreening for abdominal aortic aneurysm with ultrasonography
- DCatch-up human papillomavirus vaccination
- EScreening for osteoporosis with dual-energy x-ray absorptiometry
Answer
Annual low-dose computed tomography of the chest and screening colonoscopy
The correct interventions are annual low-dose computed tomography (LDCT) of the chest and screening colonoscopy. According to current USPSTF guidelines, adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years require annual lung cancer screening with LDCT. This patient is 50 years old with a 30 pack-year history, making him an ideal candidate. Additionally, colorectal cancer screening is recommended for average-risk adults beginning at age 45. Since the patient has not received any medical care in 15 years, he is overdue for a screening colonoscopy.
Step-by-Step Solution
Key Concept
Age-appropriate and risk-based preventive screening guidelines for adults