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Primary Care Guidance for Persons With HIV - 2021

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27 Table 5. Routine Healthcare Maintenance for People With HIV (After Initial Assessment) Intervention Recommendation Comments Screening for and Prevention of Cancer Smoking Recommend cessation (if presently smoking ) at every visit. Provide resources per local guidelines, including classes/agents that facilitate smoking cessation. Low dose chest CT scan For smokers. Between ages 55–80 who have 30 pack-years of smoking and are current smokers or have quit in the last 15 years should have an annual low-dose computed tomography scan of lung until smoking has been discontinued for 15 years. Prostate cancer screening Digital rectal exam: Considered primary evaluation before PSA screening. Consider for men aged 55–69. PSA screening : Age 50–69: Discuss risks and potential benefits with patient. Age ≥70: PSA screening is NOT recommended. e impact of HIV on prostate cancer risk is not yet known. African- Americans and people with a relative with prostate cancer have a higher burden of prostate cancer. Clinicians should follow USPSTF or American Cancer Society guidelines, and consider patient wishes. Colon cancer screening Age 45–75 years if average risk (including personal and family history). Age 76–85 years: individualize screening based on overall health and prior screening. Screening tests include: Stool-based screening (gFOBT, FIT, FIT-DNA) every year, or colonoscopy every 10 years if normal, or more frequently if polyps are identified. Breast cancer screening Age 50–75: Mammography performed at least every 2 years. Age 40–49: Inform of the potential risks and benefits of screening and offer screening every 2 years. See Section IV for further discussion. (cont'd)

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