Morbidity and Mortality Weekly Report (MMWR)

MMWR

Appendix F: Screening Services For Which Evidence Does Not Support Screening

The following services have been given a D recommendation from the U.S. Preventive Services Task Force (USPSTF), which indicates that the potential harms of routine screening outweigh the benefits. Providers should not perform these screening services.

The USPSTF has recommended against offering the following services to women and men:

Asymptomatic bacteriuria: USPSTF recommends against screening for asymptomatic bacteriuria in men and nonpregnant women (1).
Gonorrhea: USPSTF recommends against routine screening for gonorrhea infection in men and women who are at low risk of infection (2).
Hepatitis B: USPSTF recommends against routinely screening the general asymptomatic population for chronic hepatitis B virus infection (3).
Herpes simplex virus (HSV): USPSTF recommends against routine serological screening for HSV in asymptomatic adolescents and adults (4).
Syphilis: USPSTF recommends against screening of asymptomatic persons who are not at increased risk of syphilis infection (5).

The USPSTF has recommended against offering the following services to women:

BRCA mutation testing for breast and ovarian cancer susceptibility: USPSTF recommends against routine referral for genetic counseling or routine breast cancer susceptibility gene (BRCA) testing for women whose family history is not associated with an increased risk of deleterious mutations in breast cancer susceptibility gene 1 (BRCA1) or breast cancer susceptibility gene 2 (BRCA2) (6). However, USPSTF continues to recommend that women whose family history is associated with an increased risk of deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for BRCA testing.
Breast self-examination: USPSTF recommends against teaching breast self-examination (7).
Cervical cytology: USPSTF recommends against routine screening for cervical cancer with cytology (Pap smear) in the following groups: women aged <21 years, women aged >65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer, women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion (i.e., cervical intraepithelial neoplasia grade 2 or 3) or cervical cancer. USPSTF recommends against screening for cervical cancer with HPV testing, alone or in combination with cytology, in women aged <30 years (8).
Ovarian cancer: USPSTF recommends against routine screening for ovarian cancer (9).

The USPSTF has recommended against offering the following services to men:

Prostate cancer: USPSTF recommends against prostate-specific antigen (PSA)-based screening for prostate cancer (10).
Testicular cancer: USPSTF recommends against screening for testicular cancer in adolescent or adult males (11).

References

US Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2008. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspsbact.htm.
US Preventive Services Task Force. Screening for gonorrhea. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2005. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm.
US Preventive Services Task Force. Screening for hepatitis B infection. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2004. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspshepb.htm.
US Preventive Services Task Force. Screening for genital herpes: recommendation statement. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2005. Available at http://www.uspreventiveservicestaskforce.org/uspstf05/herpes/herpesrs.htm.
US Preventive Services Task Force. Screening for syphilis infection. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2004. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspssyph.htm.
US Preventive Services Task Force. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2013. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm.
US Preventive Services Task Force. Screening for breast cancer. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2009. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.
US Preventive Services Task Force. Screening for cervical cancer. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2012. Available at www.uspreventiveservicestaskforce.org/uspstf11/cervcancer/cervcancerrs.htm.
US Preventive Services Task Force. Screening for ovarian cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2012. Available at http://www.uspreventiveservicestaskforce.org/uspstf12/ovarian/ovarcancerrs.htm.
US Preventive Services Task Force. Screening for prostate cancer. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2012. Available at http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm.
US Preventive Services Task Force. Screening for testicular cancer. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2011. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspstest.htm.

Lead Authors

Loretta Gavin, PhD, Division of Reproductive Health, CDC

Susan Moskosky, MS, Office of Population Affairs, CDC

Systematic Review Authors and Presenters

Anna Brittain, MHS, Division of Reproductive Health, CDC

Marion Carter, PhD, Division of Reproductive Health, CDC

Kathryn Curtis, PhD, Division of Reproductive Health, CDC

Emily Godfrey, MD, Division of Reproductive Health, CDC

Arik V. Marcell, MD, The Johns Hopkins University and the Male Training Center

Cassondra Marshall, MPH, Division of Reproductive Health, CDC

Karen Pazol, PhD, Division of Reproductive Health, CDC

Naomi Tepper, MD, Division of Reproductive Health, CDC

Marie Tiller, PhD, MANILA Consulting Group, Inc.

Stephen Tregear, DPhil, MANILA Consulting Group, Inc.

Michelle Tregear, PhD, MANILA Consulting Group, Inc.

Jessica Williams, MPH, MANILA Consulting Group, Inc.

Lauren Zapata, PhD, Division of Reproductive Health, CDC

Expert Work Group

Courtney Benedict, MSN, Marin Community Clinics

Jan Chapin, MPH, American College of Obstetricians and Gynecologists

Clare Coleman, President and CEO, National Family Planning and Reproductive Health Association

Vanessa Cullins, MD, Planned Parenthood Federation of America

Daryn Eikner, MS, Family Planning Council

Jule Hallerdin, MN, Advisor to the Office of Population Affairs

Mark Hathaway, MD, Unity Health Care and Washington Hospital Center

Seiji Hayashi, MD, Bureau of Primary Health Care, Health Resources and Services Administration

Beth Jordan, MD, Association of Reproductive Health Professionals

Ann Loeffler, MSPH, John Snow Research and Training Institute

Arik V. Marcell, MD, The Johns Hopkins University and the Male Training Center

Tom Miller, MD, Alabama Department of Health

Deborah Nucatola, MD, Planned Parenthood Federation of America

Michael Policar, MD, State of California and UCSF Bixby Center

Adrienne Stith-Butler, PhD, Keck Center of the National Academies

Denise Wheeler, ARNP, Iowa Department of Public Health

Gayla Winston, MPH, Indiana Family Health Council

Jacki Witt, MSN, Clinical Training Center for Family Planning, University of Missouri—Kansas City

Jamal Gwathney, MD, Bureau of Primary Health Care, Health Resources and Services Administration

Technical Panel on Women's Clinical Services

Courtney Benedict, MSN, Marin Community Clinics

Janet Chapin, MPH, American College of Obstetricians and Gynecologists

Elizabeth DeSantis, MSN, South Carolina Department of Health and Environmental Control

Linda Dominguez, CNP, Southwest Women's Health

Eileen Dunne, MD, Division of STD Prevention, CDC

Jamal K. Gwathney, MD, Bureau of Primary Health Care, Health Resources and Services Administration

Jule Hallerdin, Consultant Advisor

Mark Hathaway, MD, Washington Hospital Center

Arik V. Marcell, MD, Johns Hopkins University and the Male Training Center

Cheri Moran, University of Illinois Medical Center at Chicago

Deborah Nucatola, MD, Planned Parenthood Federation of America

Michael Policar, MD, Family PACT Program - California State Office of Family Planning

Pablo Rodriguez, MD, Women's Care Inc., Providence Office

Denise Wheeler, ARNP, Iowa Department of Public Health

Jacki Witt, MSN, Clinical Training Center for Family Planning, University of Missouri—Kansas City

Technical on Men's Clinical Services

Linda Creegan, FNP, California STD/HIV Prevention Training Center

Dennis Fortenberry, MD, Indiana University School of Medicine

Emily Godfrey, MD, University of Illinois at Chicago

Wendy Grube, PhD, University of Pennsylvania School of Nursing

Arik V. Marcell, MD, The Johns Hopkins University and the Male Training Center

Elissa Meites, MD, Division of STD Prevention, CDC

Anne Rompalo, MD, Johns Hopkins University

Thomas Walsh, MD, University of Washington Medical Center

Jacki Witt, MSN, Clinical Training Center for Family Planning, University of Missouri—Kansas City

Sandra Wolf, MD, Women's Care Center, Philadelphia

Technical Panel on Adolescents

Claire Brindis, DrPH, University of California, San Francisco

Gale Burstein, MD, SUNY at Buffalo School of Medicine and Biomedical Sciences, Department of Pediatrics

Laura Davis, MA, Advocates for Youth

Patricia J. Dittus, PhD, Division of STD Prevention, CDC

Paula Duncan, MD, University of Vermont College of Medicine

Carol Ford, MD, The Children's Hospital of Philadelphia

Melissa Gilliam, MD, The University of Chicago

Mark Hathaway, MD, Unity Health Care & Washington Hospital Center

Deborah Kaplan, PhD, New York City Department of Health and Mental Hygiene

Arik V. Marcell, MD, The Johns Hopkins University and the Male Training Center

Brent C. Miller, PhD, Utah State University

Elizabeth M. Ozer, PhD, Division of Adolescent Medicine, University of California, San Francisco

John Santelli, MD, Columbia University, Mailman School of Public Health

Technical Panel on Counseling and Education

Beth Barnet, MD, University of Maryland

Betty Chewning, PhD, University of Wisconsin School of Pharmacy

Christine Dehlendorf, MD, University of California, San Francisco

Linda Dominguez, CNP, Southwest Women's Health

Jillian Henderson, PhD, University of California, San Francisco

James Jaccard, PhD, New York University

Beth Jordan, MD, Association of Reproductive Health Professionals—East

David Kaplan, PhD, American Counseling Association

Alicia Luchowski, American Congress of Obstetricians and Gynecologists

Merry-K Moos, FNP, University of North Carolina at Chapel Hill

Patricia Murphy, DrPH, University of Utah College of Nursing

Elizabeth O'Connor, PhD, Kaiser Permanente Center for Health Research

Jeff Peipert, MD, Washington University in St. Louis

Technical Panel on Quality Improvement

Davida Becker, PhD, Bixby Center for Global Reproductive Health University of California, San Francisco

Peter Briss, MD, National Center for Chronic Disease Prevention and Health Promotion, CDC

Denise Dougherty, PhD, Agency for Healthcare Research and Quality

Daryn Eikner, MS, Family Planning Council

Christina I. Fowler, PhD, RTI International

Evelyn Glass, MSPH, Consultant Advisor

Yvonne Hamby, MPH, Regional Quality Improvement and Infertility Prevention Programs

A. Seiji Hayashi, MD, Bureau of Primary Health Care, Health Resources and Services Administration

Michael D. Kogan, PhD, Health Resources and Services Administration /Maternal and Child Health Bureau

Tom Miller, MD, Alabama Department of Health

Sam Posner, PhD, National Center for Chronic Disease Prevention and Health Promotion, CDC

Donna Strobino, PhD, Johns Hopkins University

Amy Tsui, PhD, Johns Hopkins Bloomberg School of Public Health

Reva Winkler, MD, National Quality Forum

Adivsors on Community Outreach and Participation*

Paula Baraitser, MBBS, Kings College Hospital NHS Foundation Trust/Health Protection Agency

Joy Baynes, MPH, Advocates for Youth

Diane Chamberlain, California Family Health Council

Clare Coleman, National Family Planning & Reproductive Health Association

Emily Godfrey, MD, University of North Carolina and Division of Reproductive Health, CDC

Rachel Gold, MPA, Guttmacher Institute

Rachel Kachur, MPH, Division of STD Prevention, CDC

Michelle Kegler, PhD, Rollins School of Public Health, Emory

Eleanor McLellan-Lemal, PhD, Division of HIV/AIDS Prevention, CDC

Paula Parker-Sawyers, National Campaign to Prevent Teen and Unplanned Pregnancy

Denise Wheeler, MS, Iowa Department of Public Health

Gayla Winston, MPH, Indiana Family Health Council, Inc.

CDC and Office of Population Affairs Reviewers

Wanda Barfield, MD, Division of Reproductive Health, CDC

Gail Bolan, MD, Division of STD Prevention, CDC

Linda Dahlberg, PhD, Division of Violence Prevention, CDC

Patricia Dietz, PhD, Division of Reproductive Health, CDC

Sherry Farr, PhD, Division of Reproductive Health, CDC

Evelyn Glass, MSPH, Office of Population Affairs

Tamara Haegerich, PhD, Division of Violence Prevention, CDC

David Johnson, MPH, Office of Population Affairs

Pamela Kania, MS, Office of Population Affairs

Marilyn Keefe, MPH, Deputy Assistant Secretary for Population Affairs

Dmitry Kissin, MD, Division of Reproductive Health, CDC

Nancy Mautone-Smith, MSW, Office of Population Affairs

Jacqueline Miller, MD, Division of Cancer Prevention and Control, CDC

Sam Posner, PhD, National Center for Chronic Disease and Health Promotion, CDC

Cheryl Robbins, PhD, Division of Reproductive Health, CDC

Lance Rodewald, MD, Division of Immunization Services, CDC

Mona Saraiya, MD, Division of Cancer Prevention and Control, CDC

Van Tong, MPH, Division of Reproductive Health, CDC

Lee Warner, PhD, Division of Reproductive Health, CDC

Kim Workowski, MD, Division of STD Prevention, CDC

External Reviewers

Paula Braverman, MD, Department of Pediatrics at the University of Cincinnati

Claire Brindis, DrPH, University of California–San Francisco

Sarah Brown, MPH, National Campaign to Prevent Teen and Unplanned Pregnancy

Marji Gold, MD, Albert Einstein School of Medicine

Milton Kotelchuck, PhD, Massachusetts General Hospital for Children and Harvard Medical School

David Levine, MD, Morehouse School of Medicine

Pamela Murray, MD, West Virginia University School of Medicine

Competing interests for the development of these guidelines were not assessed.

* These persons made important contributions to a discussion about community outreach and participation. A decision was made to narrow the focus of this report to clinical services, so recommendations informed by the input of these persons will be published separately.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

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Morbidity and Mortality Weekly Report (MMWR)

Appendix F: Screening Services For Which Evidence Does Not Support Screening

References

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