Dive Brief:
- The American Academy of Pediatrics' new screening recommendations, 2016 Recommendations for Preventative Pediatric Health Care, focus more on preventative testing to identify disease risk factors early.
- The new tests include anemia at 15 and 30 months, cervical dysplasia only at age 21 (no longer annually from ages 11 to 20), congenital heart disease prior to newborn discharge, cholesterol for children ages 9 to 11, dental (fluoride varnish applications from 6 months through 5 years), depression (annually for ages 11 to 21), drugs and alcohol (all adolescents), HIV (ages 16 to 18), and vision (routine screening at age 18 has been changed to risk-based assessment).
- The drugs and alcohol screening involves the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) questionnaire and is recommended for all adolescents. This consists of six questions regarding the use of drugs and alcohol that an adolescent can answer with a simple "Yes" or "No," according to the Center for Adolescent Substance Abuse Research.
Dive Insight:
The guidelines are being updated to address risk factors early in cases where treatment can make a difference. For example, atherosclerosis, a fatty build up in the arteries that can lead to a stroke or heart attack, begins in the young. Diet and lifestyle changes are recommended to lower cholesterol levels, and medication should be reserved for extreme cases. Dr. Geoffrey Simon, the author of the report, said, "The goal is to identify risk factors early on, so we can reduce their heart disease risk as adults."
HIV testing is being recommended for teens ages 16 to 18 at least once in a healthcare setting where the prevalence of HIV in the patient population is more than 0.1%, and in areas of lower prevalence, routine HIV testing is encouraged for all sexually active adolescents. Young adults ages 13 to 24 account for 25% of new HIV infections and 60% of those infected are unaware of their status.
Annual depression screening is recommended for ages 11 to 21 because suicide is now the leading cause of death in adolescents.