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Clinical Guidelines

Key Changes to Preventive Guidelines

  • Aspirin — Now limited to those individuals whose benefits exceed harms. Explanation in text of how to calculate risk and harm values for each patient.
  • Breast Cancer Mammography Screening —adopted USPSTF and American College of Physicians recommendations to screen ages 50 — 74 with mammography every 2 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms.
  • HIV, Hep B, TB — references updated, risk groups spelled out in detail.
  • Osteoporosis — Screen all women age = 65 and younger women whose FRAX score is 9.3% or higher (fracture risk of average 65 year old woman).
  • Cervical Cancer Screening — every 2 years ages 21 — 29, every 3 years ages 30 - 64.
  • Tdap Vaccine — Offer ONCE to all ages 7 and older in place of a routine tetanus booster. May give a month after receiving Td. No older age limit. Important especially to immunize caregivers of young children to reduce Pertussis epidemic.

Questions or Comments

Annie Cherayil, MD
CCHP Medical Consultant
595 Center Ave., Suite 100
Martinez, CA 94553
Email: annie.cherayil@hsd.cccounty.us
Telephone: 925-370-5158






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