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Individual Preventive Screening

Review the clinician provider guidelines and recommendations from the United States Preventive Services Task Force A and B Recommendations.
For the master’s-prepared nurse, knowledge of epidemiology and its application to preventive screening guidelines is important in many clinical areas: administrative, education, and nurse practitioner fields. Individual patient preventive screenings are ordered as a secondary measure before symptoms occur. Preventive screenings are recommended based on outcome data from epidemiological studies, that the test is beneficial; based on risk and characteristics of the identified population in the screening guideline.
Select one screening below from the United States Preventive Services Task Force guidelines.
• Abdominal aortic aneurysm
• Breast cancer
• Cervical cancer
• Colon cancer
• Diabetes mellitus II
• Lung cancer
Condition and Screening
• Define the condition and type of screening.
Epidemiology of Condition
• Discuss the epidemiology of the condition in the United States, via three statistical terms. Include the mortality and related morbidity statistics in numerical format and address trends. Include 3 comparisons: related disparities, such as race, sex, age, etc. Clearly state an analysis of the data, identifying gaps and inequities in care. Provide trends and outcomes related to screening benefits in numerical statistics.
Methodology
• Incorporate the described USPSTF guideline development methodology process, (How the guideline was developed).
• Discuss the preventive guideline criteria, the population, and provide details on the screening tool.
• Include detailed risk factors. If there is a risk prediction tool, include this.
Critical Analysis
• Conduct a literature review of the guideline's support used for its development. You may include alternative studies found in more recent literature supporting or offering alternative views.
• Identify and discuss four studies used in the guideline development clearly relating the impact on the guideline criteria for screening, tool, or population etc.
• Identify each study clearly in the paper and cite.
Summary
Provide a summary conclusion of the screening guideline, general benefit to the individual, and why it is important.
Format expectations:
• Follow all assignment directions.
• Introduction and conclusion are included.

Full Answer Section

- Fecal Immunochemical Test (FIT): This test detects hidden blood in the stool, which can be a sign of colon cancer or polyps (precancerous growths).
- Sigmoidoscopy: This procedure examines the lower part of the colon and rectum using a shorter, flexible tube with a camera.

Epidemiology of Colon Cancer

Incidence: In the United States, an estimated 151,030 new cases of colon cancer are expected to be diagnosed in 2024, with 50,630 deaths (American Cancer Society, 2024).
Mortality: The five-year relative survival rate for localized colon cancer is 91.4%, but it drops to 14.1% for distant-stage cancer (American Cancer Society, 2024).
Disparities:
- Race: African Americans have the highest colon cancer incidence and mortality rates of any racial or ethnic group in the United States (American Cancer Society, 2024).
- Socioeconomic Status: People with lower socioeconomic status are less likely to be screened for colon cancer and have poorer outcomes (Centers for Disease Control and Prevention, 2023).
- Age: The risk of colon cancer increases significantly after age 50 (American Cancer Society, 2024).

Analysis: These statistics highlight significant gaps and inequities in colon cancer care. While screening rates have improved overall, disparities persist based on race, socioeconomic status, and access to healthcare. Early detection through screening programs is crucial for improving survival rates, and addressing these disparities is essential for achieving equitable health outcomes. Trends and Outcomes: Early detection through screening has contributed to a decline in colon cancer mortality rates over the past few decades (American Cancer Society, 2024). Studies suggest that colonoscopy screening can reduce the risk of colon cancer by 50-70% (Rex et al., 2010). Methodology The USPSTF uses a rigorous methodology to develop preventive screening guidelines. This includes:

Systematic Review: A comprehensive search for relevant scientific evidence on the benefits and harms of screening tests.
Strength of Evidence Rating: Grading the quality of the evidence supporting the effectiveness of screening.
Balance of Benefits and Harms: Weighing the potential benefits of screening against the potential harms, such as false positives and complications from procedures.
Equity Considerations: Evaluating how the guideline might impact different populations and addressing potential disparities.

Preventive Guideline Criteria The current USPSTF guidelines recommend colon cancer screening for adults starting at age 45 for average-risk individuals (USPSTF, 2024). They offer different screening options with varying intervals depending on individual preferences and risk factors.

Population: Adults aged 45 and older with an average risk of colon cancer.
Screening Tool: Multiple options are available, including colonoscopy, FIT, and sigmoidoscopy, with different advantages and disadvantages.
Risk Factors: Several factors increase the risk of colon cancer, including:
- Family history: Having a close relative with colon cancer.
- Personal history of inflammatory bowel disease (IBD): Ulcerative colitis or Crohn's disease.
- Lifestyle factors: Obesity, smoking, and a diet low in fiber and high in red meat.

Critical Analysis Several studies have been instrumental in shaping the USPSTF's colon cancer screening guidelines:

The National Polyp Study (NPS): This large-scale study found that colonoscopy screening reduces the risk of colon cancer death (National Polyp Study Work Group, 2002).
The American Cancer Society Colorectal Cancer Screening Guidelines: These guidelines recommend screening starting at age 45 for average-risk individuals (American Cancer Society, 2024).
The US Multiethnic Cohort (MEC) Study: This study identified racial and ethnic disparities in colon cancer screening rates (Morrato et al., 2013).

These studies provide evidence for the effectiveness of colonoscopy screening in reducing colon cancer mortality and highlight the need to address disparities in screening rates

Sample Answer

Condition and Screening

Condition: Colon cancer is an uncontrolled growth of abnormal cells in the lining of the colon (large intestine). It is the third most common cancer diagnosed in the United States and the second leading cause of cancer death (American Cancer Society, 2024).
Type of Screening: Several tests are used for colon cancer screening, including:
- Colonoscopy: This is a visual examination of the entire colon using a long, flexible tube with a camera.