Table 4.
Screening Recommendations for Adults with ID Based on Current Evidence
| Screening | USPSTF Guideline for All Adults in the US | USPTF SOR | Evidence-Based Recommendation for Adults with ID | SORT |
|---|---|---|---|---|
| Obesity/body mass index | Yearly body mass index easurement and counselling for obese patients | B | At least yearly measurement; individualized counselling | B |
| Cholesterol/lipid | Yearly screening for men over age 35 and women over age 45 if average risk (earlier if at risk) | A | Be alert to higher incidence of risk factors in this group* | C |
| Diabetes | Yearly glucose screening if hypertensive or has hyperlipidemia* | B | Same as for cholesterol/lipid; note increased prevalence of risk | I |
| Hypertension | Yearly blood pressure measurement for adults ≥18 years of age | A | Same as for diabetes | C |
| Tobacco/smoking cessation | Regular counselling for all smokers (at least yearly) | A | Same as diabetes; individualized counselling | I |
| Colon cancer | Fecal occult blood screening ± scope yearly after age 50 | A | Same as diabetes; may combine with other tests while patient is under sedation | B |
| Breast cancer (women) | Mammogram every 1–2 years after age 39 | B | Same | C |
| Cervical cancer (women) | Pap smear yearly if sexually active | A | Pap individualized to patient’s risk factors (generally can be done less often) | B |
| Prostate cancer | Insufficient evidence to recommend | I | Same as for cervical cancer | I |
| Skin cancer | Insufficient evidence to recommend | I | Same as for cervical cancer (probably less prevalent) | I |
| Osteoporosis | Bone densitometry | B | Yearly screening beginning at age 40 for institutionalized patients and age 45 for community-dwelling patients | B |
| Vision and hearing† | Yearly in all adults | At least yearly; modified/individualize methods | B | |
| Mental health | Regular screening for depression/ mood disorders | B | Yearly with attention to physical symptoms of mood disorders | C |
*
Risk factors for CAD that would prompt earlier lipid measurement: hypertension, obesity, inactivity, family history of CAD, known diabetes or lipid disorder, cigarette smoking.
†
Vision and hearing SOR is being updated based on availability of new research (2 to 28 to 07).
USPSTF, United States Preventive Services Task Force; SOR, strength of recommendation (as designated by the USPSTF for the general population); ID, intellectual disabilities; SORT = strength of recommendation taxonomy.