Health Promotion, Disease Prevention, and Patient Education
Prevention Framework
Prevention is organized into primary (prevent disease before it occurs), secondary (early detection), and tertiary (limit disability from existing disease). Screening recommendations come from bodies such as the USPSTF, and questions test whether you know when to screen and when to stop. Key examples: colorectal cancer screening from age 45 to 75; cervical cancer screening with cytology or HPV testing depending on age; mammography individualized from 40 to 74; lung cancer screening with low-dose CT for high-risk smokers. Immunizations follow age and risk schedules, and adult vaccination status should be reviewed at every visit.
Traps to Watch
A common trap is screening a patient outside the recommended age or risk group. Another is confusing screening with diagnostic testing: a positive screen requires confirmatory workup. Counseling should be patient-centered and use shared decision-making, especially for prostate cancer screening and mammography where benefit is individualized. Health literacy matters: use teach-back to confirm understanding, avoid jargon, and provide written materials at an appropriate reading level.
Worked Example
A 50-year-old smoker asks about lung cancer screening. Trap answer: "order a chest X-ray." Correct reasoning: low-dose CT is the recommended modality for eligible high-risk adults. Rule of thumb: match the screening test to the guideline, not to convenience; confirm eligibility by age and pack-year history.