Family Medicine Question Bank

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1. For average-risk women aged 21 to 29, what is the recommended interval for cervical cancer screening using cytology (Pap smear) alone?

Women 21 to 29 should be screened with cervical cytology alone every 3 years. Primary HPV testing and co-testing are generally reserved for women 30 and older. Annual screening is not recommended because it increases harms without added benefit.

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2. According to current USPSTF guidance, at what age should average-risk adults begin screening for colorectal cancer?

The USPSTF lowered the starting age for average-risk colorectal cancer screening to 45 years, reflecting rising incidence in younger adults. Screening continues to age 75 with individualized decisions from 76 to 85. Earlier screening is reserved for those with higher-risk features such as family history.

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3. Under the 2024 USPSTF recommendation, at what age should biennial screening mammography begin for average-risk women?

The USPSTF now recommends starting biennial mammography at age 40 for average-risk women and continuing through age 74. This is a change from the prior recommendation that emphasized individualized decisions in the 40s. Biennial rather than annual screening balances benefits against false positives and overdiagnosis.

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4. Low-dose CT lung cancer screening eligibility requires a smoking history of at least how many pack-years?

Current USPSTF criteria require at least a 20 pack-year smoking history for annual low-dose CT screening. Eligible patients are aged 50 to 80 who currently smoke or have quit within the past 15 years. The threshold was lowered from 30 pack-years to broaden eligibility.

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5. A one-time ultrasound screening for abdominal aortic aneurysm is recommended for which group?

The USPSTF recommends a one-time abdominal ultrasound for men aged 65 to 75 who have ever smoked. Screening is not routinely recommended for women who have never smoked. For men in this age group who never smoked, screening is an individualized decision.

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6. At what age should osteoporosis screening with bone densitometry (DEXA) begin in average-risk women?

The USPSTF recommends screening for osteoporosis with bone density testing in women aged 65 and older. Younger postmenopausal women are screened if their fracture risk equals that of a 65-year-old woman. DEXA of the hip and spine is the standard measurement.

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7. For which age range does the USPSTF recommend shared decision-making about PSA-based prostate cancer screening?

The USPSTF recommends individualized, shared decision-making about PSA screening for men aged 55 to 69. For men 70 and older, routine PSA screening is not recommended. The discussion should weigh potential benefits against harms such as overdiagnosis and overtreatment.

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8. The USPSTF recommends one-time HIV screening for adolescents and adults in which age range?

The USPSTF recommends screening for HIV in everyone aged 15 to 65 at least once, with additional screening for those at increased risk. Younger adolescents and older adults at increased risk should also be screened. All pregnant persons should be screened as well.

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9. After a normal average-risk screening colonoscopy, what is the recommended interval before the next colonoscopy?

A normal screening colonoscopy in an average-risk adult should be repeated in 10 years. Shorter intervals apply when adenomas or other high-risk findings are detected. Colonoscopy has the longest interval of the recommended screening modalities.

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10. USPSTF recommends a statin for primary prevention in adults 40 to 75 with at least one cardiovascular risk factor and an estimated 10-year risk of at least what percent?

The USPSTF recommends initiating a statin for adults 40 to 75 with one or more risk factors and an estimated 10-year cardiovascular risk of 10 percent or greater. For risk of 7.5 to less than 10 percent, statin use is a selective, individualized decision. Risk is estimated using a validated pooled cohort equation.