Procedure Manual Appendix IX. Factors to Consider When Recommending Starting and Stopping Times for Screening

Evidence regarding the following factors should be considered when recommending initiation of screening:

  1. Whether the attributable risk and potential burden of the targeted condition is limited to or increased significantly in subgroups who are easily identified by one or more of the following factors: age, sex, ethnicity, particular behaviors (e.g., sexually active), and/or comorbid conditions or biological risk factors.
  2. Whether the potential to avert risk and burden is decreased by competing risks, such as short life expectancy.
  3. Whether the accuracy of available screening tests differs or is uncertain in particular subgroups.
  4. Whether the feasibility, efficacy, and/or harms of treatment of the risk factor or target condition differ in particular subgroups.
  5. Whether available research on the items above is limited to particular subgroups, especially if there is biological or epidemiological knowledge suggesting that the risk for disease, the accuracy of the screening test, and/or the efficacy of the treatment may vary significantly across a particular subgroup.

Evidence regarding the following factors should be considered when recommending termination of screening:

  1. Whether the attributable risk and potential burden of the targeted condition is absent or decreased significantly in subgroups who are easily identified by one or more of the following factors: age, sex, ethnicity, particular behaviors (e.g., not sexually active), and/or biological or physical factors (e.g., surgical removal of the target organ).
  2. Whether the potential to avert risk and burden is decreased by competing risks, such as short life expectancy.
  3. Whether the accuracy of available screening tests differs or is uncertain in particular subgroups.
  4. Whether the feasibility, efficacy, and/or harms of treatment of the risk factor or target condition differ in particular subgroups.
  5. Whether available research on the items above is limited to particular subgroups, especially if there is biological or epidemiological knowledge suggesting that the risk for disease, the accuracy of the screening test, and/or the efficacy of the treatment may vary significantly across a particular subgroup.
  6. Whether the natural history of the target condition suggests a long development or precursor period and prior screening tests have been negative.

Current as of: July 2017
Internet Citation: Appendix IX. Factors to Consider When Recommending Starting and Stopping Times for Screening. U.S. Preventive Services Task Force. July 2017.

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