Table 3.

USPSTF Grade D Preventive Services by Utilization Volume and Costs

Low-value preventive service	Mean annual count	95% CI of count	Percent of total utilization	Cost per service	Mean annual cost per service (millions)	95% CI of costs	Percent of total costs for selected services	Rank by costs	Rank by utilization
Screening for bacteriuria in asymptomatic adults	14,144,166	12,711,424–15,576,907	45.6%	$12	$169,729,992	$152,537,088–$186,922,884	35.5%	1	1
Vitamin D supplementation for primary prevention of fractures among postmenopausal women	11,911,788	10,533,189–13,290,388	38.4%	$7	$83,382,516	$73,732,323–$93,032,716	17.4%	2	2
Prostate cancer screening for men 75 years and oldera	1,786,701	1,476,497–2,096,905	5.8%	$26	$46,454,226	$38,388,922–$54,519,530	9.7%	5	3
Cervical cancer screening for women over 65 years	1,403,434	1,125,581–1,681,286	4.5%	$40	$56,137,360	$45,023,240–$67,251,440	11.7%	4	4
COPD screening among asymptomatic adults	877,922	535,540–1,220,304	2.8%	$37	$32,483,114	$19,814,980–$45,151,248	6.8%	6	5
Screening low-risk asymptomatic adults for cardiovascular disease with either rest/stress ECG	785,939	618,449–953,430	2.5%	$26	$20,434,414	$16,079,674–$24,789,180	4.3%	7	6
Colon cancer screening over 85 yearsb	137,441	62,736–212,147	0.4%	$504	$69,270,264	$31,618,944–$106,922,088	14.5%	3	7
Total	31,047,391	27,063,416–35,031,367	100%		$477,891,886	$377,195,171–$578,589,086	100.0%

^aThe Grade D rating for prostate cancer screening among men 75 and older was active from 2008 to 2012, expanded to all men from 2012 to 2018 and revised to men 70 and older in 2018. For consistency in measurement, we applied the 2008–2012 specification across all available years

^bThe Grade D rating for colon cancer screening in adults over 85 years of age is currently undergoing USPSTF review for possible revision