New recommendations included in the updated Preventive Care Checklist Form©
| TOPIC | RECOMMENDATION | SOURCE OF RECOMMENDATION |
|---|---|---|
| Education and counseling | ||
| • Calcium intake2,3 | 1000–1200 mg daily | Osteoporosis Canada (2010) Health Canada (2010) |
| • Vitamin D intake2,4 | 400–1000 IU daily for low risk 800–1000 IU (up to 2000 IU) if aged ≥ 50 y | Osteoporosis Canada (2010) SOGC (2014) |
| Physical examination | ||
| • BP5 | Removal of the previous guidelines for different BP goals for the elderly (systolic BP < 150 mm Hg if aged ≥ 80 y) Consideration to target systolic BP < 120 mm Hg in high-risk patients | Hypertension Canada (2018) |
| Functional inquiry | ||
| • Cognitive impairment6 | Do not screen asymptomatic adults (≥ 65 y of age) for cognitive impairment | CTFPHC (2015) |
| Laboratory tests and Investigations | ||
| • AAA7 | One-time screening with ultrasound for AAA for men aged 65–80 y Do not screen men > 80 y of age for AAA Do not screen women for AAA | CTFPHC (2017) |
| • Hepatitis C8 | Do not routinely screen for hepatitis C if not at elevated risk | CTFPHC (2017) |
| • Lung cancer9 | Screen those aged 55–74 y with > 30 pack-year smoking history or who quit < 15 y ago with low-dose CT Do not use chest x-ray scanning for screening | CTFPHC (2016) |
| • Colorectal cancer10 | Screen with FIT or FOBT every 2 y, or flexible sigmoidoscopy every 10 y, if aged 50–75 y Do not use colonoscopy for screening | CTFPHC (2016) |
| • Dyslipidemia11,12 | Screen with nonfasting lipid profile in men aged ≥ 40 y, women aged ≥ 40 y (or postmenopausal), or earlier if at increased risk | CCS (2016) Simplified lipid guidelines (2015) |
| Immunizations | ||
| • Pneumococcal vaccination13 | Give Pneu-P-23 vaccine to all adults ≥ 65 y Can also give Pneu-C-13 vaccine to those at high risk or to reduce individual risk if ≥ 65 y | PHAC (2016) |
| • HPV vaccination13 | To men and women with no upper age limit, if at ongoing risk | PHAC (2018) |
| • Herpes zoster vaccination13 | Recombinant herpes zoster vaccine in those aged ≥ 50 y | PHAC (2018) |
AAA—abdominal aortic aneurysm, BP—blood pressure, CCS—Canadian Cardiovascular Society, CT—computed tomography, CTFPHC—Canadian Task Force on Preventive Health Care, FIT—fecal immunochemical test, FOBT—fecal occult blood test, HPV—human papillomavirus, PHAC—Public Health Agency of Canada, Pneu-C-13—13-valent pneumococcal conjugate, Pneu-P-23—23-valent pneumococcal polysaccharide, SOGC—Society of Obstetricians and Gynaecologists of Canada.