谁在何时接受何种筛查

🧠 为什么重要

来自U.S. Preventive Services Task Force的常见成人筛查包括：结直肠癌筛查从45 to 75岁开始（每10年进行一次colonoscopy，或更频繁地进行粪便检测）；乳腺癌mammography从40 to 74岁开始每2年一次；宫颈癌从21 to 29岁开始每3年进行一次cytology检查，从30 to 65岁开始每3年进行一次cytology检查，或每5年进行一次高危HPV检测（单独检测或与cytology联合检测即cotesting）；单独HPV检测越来越受青睐，并且可以使用自采集样本；肺癌筛查针对有20 pack-year吸烟史且正在吸烟或在过去15年内戒烟的人群，从50 to 80岁开始每年进行一次低剂量CT；腹主动脉瘤筛查针对65 to 75岁曾经吸烟的男性进行一次性超声检查；骨质疏松症骨密度检查针对65岁及以上的女性，以及65岁以下骨折风险增加的绝经后女性；所有成人均应进行血压筛查；糖尿病筛查针对35 to 70岁超重或肥胖的成人；HIV筛查针对15 to 65岁人群至少进行一次；所有成人和青少年均应进行抑郁症筛查。使用PSA进行前列腺癌筛查针对55 to 69岁男性，应作为个体化的共同决策，而不是常规筛查。指南会变化；考试考查的是当前指南。

Common adult screenings from the U.S. Preventive Services Task Force: COLORECTAL cancer screening from age 45 to 75 (colonoscopy every 10 years or stool-based tests more often); BREAST cancer mammography every 2 years from age 40 to 74; CERVICAL cancer with cytology every 3 years from 21 to 29, and from 30 to 65 either cytology every 3 years or high-risk HPV testing, alone or with cytology (cotesting), every 5 years; HPV testing alone is increasingly preferred, and it can use a self-collected sample; LUNG cancer yearly low-dose CT from 50 to 80 for people with a 20 pack-year history who smoke or quit within the past 15 years; ABDOMINAL AORTIC ANEURYSM one-time ultrasound for men 65 to 75 who have ever smoked; OSTEOPOROSIS bone density for women 65 and older, and for postmenopausal women younger than 65 at increased fracture risk; BLOOD PRESSURE for all adults; DIABETES screening for adults 35 to 70 who are overweight or obese; HIV screening at least once for ages 15 to 65; DEPRESSION screening for all adults and adolescents. Prostate cancer screening with PSA for men 55 to 69 is an individual, shared decision rather than routine. Guidelines change; the exam tests the current ones.

🏥 真实场景

📅 一名52岁男性，每天抽一包烟，抽了25年，并在10年前戒烟，他认为自己“不用再担心吸烟了”。他符合每年进行低剂量CT肺部筛查的资格，直到戒烟满15年为止，并且他的结直肠癌筛查已经逾期，该筛查从45岁开始。两次谈话，都有可能挽救生命，如果护士不知道这些年龄，两次都会被错过。

📅 A 52-year-old man who smoked a pack a day for 25 years and quit 10 years ago believes he is 'done worrying about smoking'. He qualifies for annual low-dose CT lung screening until 15 years have passed since quitting, and he is overdue for colorectal screening, which started at 45. Two conversations, both potentially life-saving, both missed if the nurse does not know the ages.

📌 要点总结

• 结直肠癌筛查从45岁开始；mammography从40岁开始每两年一次Colorectal screening starts at 45; mammography at 40 every two years
• 宫颈癌：从21岁开始每3年一次；基于HPV的筛查从30岁开始每5年一次Cervical: every 3 years from 21; HPV-based every 5 years from 30
• 肺部CT：20 pack-years，50 to 80岁，正在吸烟或在15年内戒烟Lung CT: 20 pack-years, ages 50 to 80, smoking or quit within 15 years

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