CTF Quick Tables: women - all recommendations

Women 21-64 Years of Age Quick Table: All Relevant Recommendations

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Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.

Quick Table of All Recommendations Specific and Relevant to Women 21-64 Years of Age

Condition	Maneuver	Population
"A" Recommendations
Breast cancer	Mammography and clinical exam	Women aged 50-69 yrs
Colorectal cancer	Multiphase screening with the Hemoccult test	Average risk adults > age 50
Dental caries	Community fluoridation, fluoride toothpaste or supplement	General population
Dental caries, periodontal disease	Brushing and flossing teeth to apply toothpaste (A) and prevent gingivitis (B) but not cariostatic (C)	General population
Hearing impairment	Noise control and hearing protection	General population
Household and recreational injury	Public education/ Legislation on poison control	General population
Hypertension	Pharmacologic treatment	Adults aged 21-64 yrs with DBP >90 mmHg
Influenza	Influenza vaccination	General population
Influenza	Neuraminidase inhibitor prophylaxis	General population
MVA injury	Legislation, restraint use and control of drinking and driving	General population
Neural tube defects	Folic acid supplementation	Women capable of becoming pregnant
Oral cancer mortality	Smoking cessation counselling	General population
Periodontal disease	Flossing teeth	Adult population
Pneumococcal pneumonia	Single dose of 23-valent pneumococcal vaccine	Immunocompetent patients >age 55 years in institutions
Progressive renal disease	Urine dipstick	Adults with IDDM
Tobacco-caused disease	Counselling, smoking cessation or offer nicotine replacement therapy	Smokers
"B" Recommendations
All-cause mortality and morbidity	Moderate physical activity	General population
Breast cancer	Counselling on benefits and risks of using tamoxifen to reduce likelihood of breast cancer	High-risk women
Cardiovascular events	Screening for type 2 diabetes mellitus to prevent CV events	High-risk adults with hypertension
Cardiovascular events	Screening for type 2 diabetes mellitus to prevent CV events	High-risk adults with hyperlipidemia
Cardiovascular events	Acarbose treatment to prevent CV events	Overweight adults with impaired glucose tolerance
Cervical cancer	Papanicolaou smear	Women
Chlamydial infection	Smear, culture or analysis	High-risk women
Colorectal cancer	Sigmoidoscopy	Average risk adults > age 50
Colorectal cancer	Flexible sigmoidoscopy beginning at puberty, genetic testing	High-risk adults with FAP
Colorectal cancer	Colonoscopy	High-risk adults with HNPCC
Congenital rubella syndrome	Screen and vaccinate or universal vaccination	Non-pregnant women of child-bearing age
Depression	Screening in settings with integrated feedback and treatment systems	General population
Diabetes	Lifestyle interventions to reduce the incidence of progression to diabetes	Overweight adults with impaired glucose tolerance
Diet-related illness	Counselling on adverse nutritional habits	Adult population
Domestic violence	Referral to post-shelter advocacy counseling	Pregnant and non-pregnant women
Gingivitis	Brushing teeth	General population
Gonorrhea	Counselling, Educational materials	General population
Household and recreational injury	Legislation, window and stair guards, smoke detectors	General population
Household and recreational injury	Public education/ Legislation, fire burn and water (tub and swimming) safety	General population
Household and recreational injury	Legislation, avoidance of alcohol with water recreation	General population
Hypertension	Acarbose treatment to prevent CV events	Overweight adults with impaired glucose tolerance
Lung cancer	Dietary advice on green leafy vegetables and fruit	Smokers
MVA Injury	Counselling on restraint use and avoidance of drinking and driving	General population
Obesity	BMI measurement	Obese adults with obesity-related disease
Obesity	Weight-reduction therapy	Obese adults with obesity-related disease
Osteoporotic fractures (and side effects)	Counselling, hormone replacement therapy	Perimenopausal women
Periodontal disease	Tooth scaling and prophylaxis	General population
Problem drinking	Case finding and counselling	General population
Skin cancer	Counselling, sun exposure, clothing	General population
Tobacco-caused disease	Referral to validated cessation program	Smokers
Varicella vaccine	Immunization with varicella vaccine	Susceptible adults
Vehicle-related injury	Legislation, bicycle motorcycle or all terrain vehicle helmet	General population
"C" Recommendations
Abdominal aortic aneurysm	Abdominal palpation	General population
Abdominal aortic aneurysm	Abdominal ultrasound	General population
All-cause mortality and morbidity	Counselling, physical activity; prevent obesity	General population
All-cause mortality, morbidity	Measure body mass index and treat obesity	General population
Breast cancer	Screening mammography	Women aged 40-49 years at average risk of breast cancer
Breast cancer follow-up	Follow-up for local recurrence	Women having been previously diagnosed with breast cancer
Breast cancer follow-up	Follow-up for contralateral breast cancer	Women having been previously diagnosed with breast cancer
Cardiovascular disease	Acetylsalicylic acid prophylaxis	General population
Child maltreatment	Sexual abuse, abduction prevention programs	General population
Colorectal cancer	Hemoccult/sigmoidoscopy in combination	Average risk adults > age 50
Colorectal cancer	Colonoscopy	Average risk adults, high-risk adults with family history of polyps/CRC
Coronary artery disease events	Screening for total plasma homocysteine levels	General population or those at high risk for coronary artery disease events
Coronary artery disease events	Vitamin therapy (folic acid alone or with vitamin B12) to lower total plasma homocysteine levels	All populations
Coronary heart disease	Diet/drug treatment	Individuals with elevated cholesterol or LDL-C except males 30-59 yrs
Coronary heart disease	Measurement of blood total cholesterol level	General population with case-finding for males 30-59 years
Coronary heart disease	General dietary advice on fat and cholesterol	General population except males 30-69 years
D (Rh) sensitization	Repeat D (Rh) antibody screening and immunoglobin (D Ig) administration	Women undergoing specific obstetric procedures or complications
Domestic violence	Batterer/couples interventions	General population
Hemoglobinopathies	Screening for carrier status and counselling	Adult population
HIV/AIDS	History, sexual and drug use counselling	General population
HIV/AIDS	Voluntary HIV antibody screening	General population including pregnant women
Household and recreational injury	Public education/ Legislation, gun control and use of Heimlich maneuver	General population
Household and recreational injury	Counselling, household and recreational injury (except some home hazards)	Adult population
Influenza	Immunization, annual	General population <65 years
Iron deficiency anemia	Routine hemoglobin	General population
MVA injury	Counselling, helmet, alcohol use	General population
MVA injury	Monitor medical impairment	General population
Obesity	BMI measurement	General population
Obesity	Community-based obesity prevention programs	General population
Obesity	Weight-reduction therapy	Obese adults without obesity-related disease
Occupational low back pain	Use of back belts in the workplace	General population
Oral cancer	Physical exam, oral cavity	General population
Oral cancer mortality	Opportunistic screening by clinical examination	Asymptomatic patients
Osteoporosis; fractures	Counselling, weight bearing exercise	Pre- and post-menopausal women
Osteoporotic fractures	History and physical examination	Women
Ovarian cancer	Pelvic exam, transvaginal ultrasound, CA 125 or combination	High-risk women with > 1 first-degree relative with ovarian cancer
Protein/calorie malnutrition	Protein/calorie malnutrition screening	Adult population
Skin cancer	Counselling, Skin self-examination	General population
Skin cancer	Counselling, Sun block	General population
Skin cancer	Physical examination, skin	General population
Suicide	Suicide risk evaluation	General population
Thyroid cancer	Neck Palpation	Adult population
Thyroid disorders	Thyroid stimulating hormone test	Perimenopausal women
Tuberculosis	INH Prophylaxis	General population aged >35 years
Urinary infection	Urine dipstick or culture	Elderly, ambulatory women
"D" Recommendations
Bladder cancer	Urine dipstick or cytology	General population
Breast cancer	Teach breast self-examination	Women aged 40-49 and women aged 50-59
Breast cancer	Tamoxifen to reduce the risk of breast cancer	Low-risk women
Cardiovascular disease	Vitamin E	Patients with established CVD or risk factors for CVD
Cardiovascular and cerebrovascular disease	Hormone replacement therapy	Postmenopausal women
Carotid disease/ Stroke	Neck auscultation or carotid endarterectomy	General population
Cervical cancer	Human papillomavirus screening	Women
Child maltreatment	Screen for risk of maltreating children	General population
Chlamydial infection	Smear, culture or analysis	General population
Chronic diseases	Hormone replacement therapy	Menopausal women
Cystic fibrosis	DNA analysis	General population
Cystic fibrosis	Sweat test, immunoreactive trypsin and "BM meconium" test	General population
Depression	General Health Questionnaire or Zung Self-rating depression scale	General population
Diabetes mellitus	Blood glucose, fasting	Non-pregnant General Population
Gonorrhea	Gram stain/culture of cervical or urethral smear	General population
Lung cancer	Chest radiography	General population
Lung cancer	Vitamin E	General population
Oral cancer mortality	Population screening by clinical examination	General population
Osteoporotic fractures	Bone mineral density screening	Women
Ovarian cancer	Pelvic exam, transvaginal ultrasound, CA 125 or combination	Pre- and Post-menopausal Women
Pancreatic cancer	Abdominal palpation, ultrasound or serologic tumor markers	General population
Periodontal disease	Brushing with electric toothbrush	General population
Progressive renal disease	Urine dipstick	General population
"E" Recommendations
Breast cancer follow-up	Blood work and diagnostic imaging	Women having been previously diagnosed with breast cancer
Lung cancer	Sputum cytology	General population
Tuberculosis	Mantoux tuberculin skin test	General population
"I" Recommendations
Cancers (esophageal, stomach, colorectal, urological, prostate)	Vitamin E	General population
Cardiovascular disease	Vitamin E	General population and male smokers
Depression	Screening in settings without integrated feedback and treatment systems	General population
Diabetes	Metformin or acarbose treatment to prevent diabetes progression	Overweight adults with impaired glucose tolerance
Domestic violence	Screening	Pregnant or non-pregnant women
Domestic violence	Primary care counseling	Pregnant or non-pregnant women
Domestic violence	Referral to shelters	Pregnant or non-pregnant women
Domestic violence	Referral to personal and vocational counseling	Pregnant or non-pregnant women
Lung Cancer	Spiral CT scanning	General population

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