Table 2

Priorities for Improving Utilization of Clinical Preventive Services

Services (Short Name)DescriptionCPBCETotal
Childhood immunization seriesACIP childhood immunization seriesa5510
Tobacco use, brief prevention counseling, youthProvide interventions to prevent initiation, including education or brief counseling5510
Tobacco use screening and brief counseling, adultsScreen adults for tobacco use and provide brief cessation counseling and pharmacotherapy5510
Alcohol misuse screening and brief interventionScreen adults’ misuse and provide brief counseling to reduce alcohol use358b
Aspirin chemoprevention for those at higher risk of CVDLow-dose aspirin use for primary prevention of CVD in adults ages 50–59 y with ≤10%, 10-y CVD risk and other factors358
Cervical cancer screeningScreen for cervical cancer in women aged 21 to 65 y with cytology (Papanicolaou smear) every 3 y448
Colorectal cancer screeningScreen adults aged 50–75 y routinely448b
Chlamydia and gonorrhea screeningScreen for chlamydia and gonorrhea in sexually active women aged ≤24 y, and in older women at increased risk for infection347b
Cholesterol screeningScreen routinely for lipid disorders men aged >35 y, and screen younger men and women of all ages who are at increased risk of CHD. Treat with lipid-lowering medications437
Hypertension screeningMeasure blood pressure routinely in all adults and treat with antihypertensive medication to prevent the incidence of CVD437
AAA screeningScreen men aged 65–75 y who have ever smoked 1 time for abdominal aortic aneurysm, using ultrasonography246b
Healthy diet and physical activity counseling for those at higher risk of CVDOffer or refer adults who are overweight or obese with additional CVD risk factors to intensive behavioral counseling to promote healthful diet and physical activity516
HIV screeningScreen for HIV infection in adolescents and adults aged 15 to 65 y. Frequency varies by risk level246b
HPV immunizationAdminister a 3-dose series of HPV vaccine to all girls aged 11–12 y336
Influenza immunization, adultsImmunize all adults against influenza annually426b
Obesity screening, adultsScreen all adults routinely for obesity. Refer patients with a BMI of 30 kg/m2 to intensive behavioral interventions516b
Syphilis screeningScreen all persons at increased risk for syphilis infection156
Vision screening, childrenScreen children routinely between ages 3 and 5 y to detect amblyopia246b
Breast cancer screeningBiennial mammography for women aged 50–74 y; screening before age 50 y an individual decision325b
Depression screening, adolescentsScreen adolescents aged 12–18 y for depression with systems to assure accurate diagnosis, treatment, and follow-up235b
Depression screening, adultsScreen adults for depression with systems to assure accurate diagnosis, treatment, and follow-up325b
Obesity screening, children and adolescentsScreen children aged ≥6 y for obesity. Offer or refer obese children to comprehensive, intensive behavioral intervention415
Pneumococcal immunization, adultsImmunize adults aged >65 y against pneumococcal disease with PCV13 and PPSV23235b
Herpes zoster immunizationSingle dose of vaccine for adults aged >60 y134
Osteoporosis screeningScreen women aged >65 y and younger women whose fracture risk is equal to or greater than that of white women aged 65 y with no additional risk factors224
Folic acid chemopreventionWomen planning or capable of pregnancy should take a daily supplement with 0.4–0.8 mg of folic acid123
Meningococcal immunizationSingle dose of quadrivalent vaccine recommended for children aged 11 to 12 y, with a booster at age 16 y112
Tdap/Td boosterOne time Tdap and Td booster every 10 y112
  • AAA = abdominal aortic aneurysm; ACIP = Advisory Committee on Immunization Practices; BMI = body mass index; CE = cost-effectiveness; CHD = coronary heart disease; CPB = clinically preventable burden; CVD = cardiovascular disease; HIV = human immunodeficiency virus; HPV = human papillomavirus; PCV13 = pneumococcal conjugate vaccine—13 pneumococcal serotypes; PPSV23 = pneumococcal polysaccharide vaccine—23 pneumococcal serotypes; Td = tetanus, diphtheria; Tdap = tetanus, diphtheria, and pertussis.

  • a Estimate includes all recommended vaccines up to 10 years of age (diphtheria, tetanus, pertussis; measles, mumps, rubella; inactivated polio virus; Hemophilus influenzae type b; hepatitis A; hepatitis B; varicella; pneumococcal conjugate; influenza; and rotavirus) plus influenza vaccination to age 18 years.

  • b Sensitivity analysis indicated that a change of score of 2 or more is possible.