11
Screening for and Prevention of Cancer
65. All patients who smoke should be strongly encouraged to stop
smoking and offered smoking cessation assistance. Screening for
smoking should be done at every healthcare encounter.
66. Screening for prostate, breast, lung, and colon cancer should be
conducted according to USPSTF and American Cancer Society
guidelines for the general population.
67. Biennial screening mammography is recommended for persons aged
50–74 years, as per USPSTF guidelines.
68. Persons with HIV between 21–29 years of age should have a cervical
Pap test annually. If the results of 3 consecutive cervical Pap tests
are normal, follow-up Pap screening should be in 3 years.
69. For persons >30 years of age, cervical Pap tests should be done
annually. If the results of 3 consecutive Pap tests without an HPV
test are normal, a follow-up Pap should be performed in 3 years.
If the Pap test is done with HPV testing and both the cytology and
HPV testing are negative, follow-up cervical cancer screening can be
done in 3 years after a single Pap smear.
70. Anal cancer screening: Periodic anal cytology by anal Pap test
should be performed if access to referral and high-resolution
anoscopy is available.
71. Screening for hepatocellular carcinoma every 6 months by
ultrasound with or without alpha-fetoprotein is recommended for
those with cirrhosis from any cause.
