Disease Prevention And Health Maintenance

Disease Prevention And Health Maintenance : 

Preventive medicine can be categorized as primary, second-ary, or tertiary. Primary prevention aims to remove or reduce disease risk factors (eg, immunization, giving up or not starting smoking). Secondary prevention techniques promote early detection of disease or precursor states (eg, routine cervical Papanicolaou screening to detect carcinoma or dysplasia of the cervix). Tertiary prevention measures are aimed at limiting the impact of established disease (eg, partial mastectomy and radiation therapy to remove and control localized breast cancer). Table 1-1 gives data for deaths from preventable causes in the United States. Table 1-2 compares recommendations for periodic health examinations as developed by the United States Preventive Services Task Force, the American College of Physicians, and the Canadian Task Force on the Periodic Health Examination. Despite emerging consensus on many of the services, controversy persists for others. Many effective preventive services are underutilized. and few adults receive all of the most strongly recommended services. In 2006, the National Commission on Prevention Priorities ranked clinical preventive service recommendations up to December 2004. The three highest-ranking services were discussing aspirin use with high-risk adults, tobacco-use screening and brief interventions, and immunizing children. Other high-ranking services with data indicating low current utilization rates (< 50%) included screening adults aged 50 and older for colorectal cancer, iminunizing adults aged 65 and older against pneumococcal disease' and screening young women for Chlarnydia. Several methods, including the use of reminder systems or financial incentives, can increase utilization of preventive services, but such methods have not been widely adopted.

Table: 1-2