A patient who recently turned 65 years old presents to establish care at a new primary care practice. His past medical history is unremarkable, and he takes no medications. He mentions that he has smoked one pack of cigarettes per day since he was 25 years old and continues to smoke. He feels well and denies any respiratory symptoms, changes in bowel habits, or abdominal pain. He has not seen a physician in over 15 years and has never undergone any formal health maintenance screenings. Based on current guidelines, which of the following preventive interventions are strongly indicated for this patient? (Select all that apply)
- Annual screening for lung cancer with a non-contrast chest CTAnswer
- One-time screening for abdominal aortic aneurysm via abdominal ultrasoundAnswer
- Colorectal cancer screening with a stool-based test or endoscopyAnswer
- DOsteoporosis screening via central bone densitometry
- ECoronary artery disease screening with a resting electrocardiogram
Answer
The indicated preventive screenings for this patient are annual screening for lung cancer with a non-contrast chest CT, a one-time screening for an abdominal aortic aneurysm via abdominal ultrasound, and colorectal cancer screening with a stool-based test or endoscopy.
The correct interventions are based directly on current USPSTF guidelines. Annual lung cancer screening with a non-contrast chest CT is indicated for adults aged 50 to 80 years with at least a 20 pack-year smoking history who currently smoke or quit within the last 15 years. A one-time abdominal ultrasound for abdominal aortic aneurysm screening is indicated for men aged 65 to 75 who have ever smoked. Finally, colorectal cancer screening is universally recommended for all average-risk adults between the ages of 45 and 75.
Step-by-Step Solution
Key Concept
Age- and risk-based preventive screening guidelines for older adults