Table 4.

Screening Recommendations for Adults with ID Based on Current Evidence

ScreeningUSPSTF Guideline for All Adults in the USUSPTF SOREvidence-Based Recommendation for Adults with IDSORT
Obesity/body mass indexYearly body mass index measurement and counselling for obese patientsBAt least yearly measurement; individualized counsellingB
Cholesterol/lipidYearly screening for men over age 35 and women over age 45 if average risk (earlier if at risk)ABe alert to higher incidence of risk factors in this group*C
DiabetesYearly glucose screening if hypertensive or has hyperlipidemia*BSame as for cholesterol/lipid; note increased prevalence of riskI
HypertensionYearly blood pressure measurement for adults ≥18 years of ageASame as for diabetesC
Tobacco/smoking cessationRegular counselling for all smokers (at least yearly)ASame as diabetes; individualized counsellingI
Colon cancerFecal occult blood screening ± scope yearly after age 50ASame as diabetes; may combine with other tests while patient is under sedationB
Breast cancer (women)Mammogram every 1–2 years after age 39BSameC
Cervical cancer (women)Pap smear yearly if sexually activeAPap individualized to patient's risk factors (generally can be done less often)B
Prostate cancerInsufficient evidence to recommendISame as for cervical cancerI
Skin cancerInsufficient evidence to recommendISame as for cervical cancer (probably less prevalent)I
OsteoporosisBone densitometryBYearly screening beginning at age 40 for institutionalized patients and age 45 for community-dwelling patientsB
Vision and hearingYearly in all adultsAt least yearly; modified/individualize methodsB
Mental healthRegular screening for depression/mood disordersBYearly with attention to physical symptoms of mood disordersC
  • * Risk factors for CAD that would prompt earlier lipid measurement: hypertension, obesity, inactivity, family history of CAD, known diabetes or lipid disorder, cigarette smoking.

  • Vision and hearing SOR is being updated based on availability of new research (2 to 28 to 07).

  • USPSTF, United States Preventive Services Task Force; SOR, strength of recommendation (as designated by the USPSTF for the general population); ID, intellectual disabilities; SORT = strength of recommendation taxonomy.