Preventative Care & Screening
for Men and/or Women

Starting at age 50. If there is a family history/symptoms, fecal occult blood test is done every 2 years.

These recommendations apply to adults aged ≥50 years who are not at high risk for colorectal cancer (CRC). They do not apply to those with previous CRC or polyps, inflammatory bowel disease, signs or symptoms of CRC, history of CRC in one or more first degree relatives, or adults with hereditary syndromes predisposing to CRC (e.g. familial adenomatous polyposis, Lynch Syndrome).

  • Flexible Sigmoidoscopy – age 50-74 yrs. Regular screening every 10 years.
  • FIT test/FOBT (Fecal Occult Blood Test) beginning at age 50 – 74 yrs. for men & women. Regular screening is every 2 years.
  • Colonoscopy as a screening test for CRC not recommended. If risk (1st degree relative ≤60yo CRC, high risk adenomas, or 2+ relatives) consider screening colonoscopy at 40yo or 10y prior to index case.

Speak to your physician to determine if this screening is right for you.

Low-dose CT scan – For adults aged 55-74 with at least a 30 pack/year smoking history, who currently smoke or quit less than 15 years ago. We recommend annual screening with Low-dose CT scan up to three consecutive times.

Chest X-Ray – We recommend that chest x-ray not be used to screen for lung cancer, with or without sputum cytology

Bone Mineral Density BMD – starting at age 65.

Screening tools FRAX, CAROC.

A1C or FPG (Fasting plasma glucose) – starting at age 40 every 3 years or earlier if high risk (FINDRISC) = https://www.mdcalc.com/findrisc-finnish-diabetes-risk-score

  • Albumin: Creatinine ratio (ACR) < 2 and kidney function (eGFR) yearly.
  • Screen for retinopathy, neuropathy and nephropathy annually.
  • CTFPHC recommends not screening patients low-moderate risk (using validated calculator such as FINDRISC).

Non-fasting lipids – starting at age 40 every 5 years or earlier if risk.

Validated calculator – Framingham Risk Score (FRS)

Starting at age 18. HTN if BP is great than 140/90.

Gonorrhea, Chlamydia, Syphilis, HIV if sexually active or risk.

  • CTFPHC recommends Gonorrhea/Chlamydia for opportunistic annual screening for (non-high risk) sexually active <30 years old
  • Consider Hepatitis B – HBV (if not immunized)

HCV

  • CTFPHC recommends against screening adults who are not at elevated risk
  • This recommendation does not apply to pregnant women, or adults who are at elevated risk – including IVDU, incarcerated, immigrants from Hepatitis C endemic region, recipient of blood products before 1992 in Canada, needle stick injuries, engaged in other risks with HCV exposure

Smoking Cessation

  • Canadian Taskforce recommends asking all children/youth and parents about tobacco use, and brief intervention (attitudes, beliefs, risks, strategies, printed/electronic material) to prevent smoking
  • Alcohol intake ≤10 drinks/w (≤2/d) for women, ≤15 drinks/w (≤3/d) for men
  • 150 min/w of moderate-vigorous intensity exercise
  • Balanced diet (vegetables, whole grains, healthy fat)
    • Limit trans and saturated fats
    • <2000mg daily sodium intake (1 tsp. of salt)
    • Increase fiber (vegetables)
  • Limit sun exposure (e.g. sunscreen, protective clothing)
  • STI/contraception counseling
  • Supplement
    • Vitamin D 400-2000 IU daily, if age>50 years (or risk) 800-2000IU daily
    • Calcium 1200 mg/d from diet (increase to 1500-2000 mg/d if pregnant or lactating)
    • Folic acid 0.4-1mg daily for all women of childbearing age