While vaccines and screenings often feel like mundane checkboxes, they form a powerful, often invisible shield—consider that global vaccination efforts have prevented an estimated 14.8 million deaths since 2000, and a simple mammogram can reduce breast cancer mortality by up to 40%.
Key Takeaways
- According to the CDC, in 2021-2022, 92.7% of children aged 24 months received the recommended 3 doses of Hepatitis B vaccine
- The WHO reports that global DTP3 coverage among 1-year-olds was 84% in 2022, preventing an estimated 14.8 million deaths since 2000
- CDC data shows 91.9% kindergarteners had MMR vaccine in 2022-2023 school year
- Mammography screening rates among US women aged 50-74 reached 77.2% in 2020 per CDC NHIS
- Colorectal cancer screening (up-to-date) 68.9% US adults 45-75 in 2022 per CDC
- Cervical cancer screening (Pap/HPV within 3 yrs) 83.3% US women 21-65 2020 CDC
- Blood pressure screening detects hypertension in 45% US adults 18+ annually per CDC 2021 NHIS
- Cholesterol screening LDL <100 mg/dL goal 55% US adults 40-79 2017-2020 NHANES
- USPSTF aspirin primary prevention CVD risk reduction 10-12% ages 40-59 high risk
- HbA1c screening detects prediabetes 36.5 million US adults CDC 2022
- USPSTF lifestyle intervention DPP reduces diabetes incidence 58% high-risk adults
- OGTT screening 2-hr glucose >=140 mg/dL prediabetes 10.7% US NHANES 2017-20
- Daily aspirin use among US adults 18-24% NHIS 2020 CDC
- Tobacco cessation quit rates 7.4% US adults past year 2021 NHIS CDC
- Physical activity 150+ min/wk moderate 23.9% US adults 2018 BRFSS CDC
Preventive care saves lives through widespread vaccination and routine cancer screenings.
Cancer Screening
- Mammography screening rates among US women aged 50-74 reached 77.2% in 2020 per CDC NHIS
- Colorectal cancer screening (up-to-date) 68.9% US adults 45-75 in 2022 per CDC
- Cervical cancer screening (Pap/HPV within 3 yrs) 83.3% US women 21-65 2020 CDC
- USPSTF: Breast cancer screening mammography reduces mortality by 20-40% in women 40-74
- Lung cancer LDCT screening eligibility 8.8 million US adults 50-80 2022 per NCI
- Prostate cancer PSA screening 35% US men 50-74 2020 NHIS CDC
- Skin cancer screening by derm exam 18.5% US adults ever screened per 2020 BRFSS
- WHO: Cervical screening prevents 74% of invasive cancers if 70% coverage 30-49 yrs
- NCI SEER: Mammography screening detects 85% early-stage breast cancers
- Colonoscopy within 10 yrs 62.4% US adults 45-75 2022 CDC
- FIT testing annual 23.1% US adults 2022 CDC PLCOm2018 model
- HPV testing with Pap 65% US women 30-65 2020 CDC
- Low-dose CT lung screening uptake 5.8% eligible US 2022 per ACC
- Melanoma early detection via screening reduces mortality 48% per AAD
- FOBT/FIT/sigmoidoscopy combo 72% CRC screening US 2021 CDC
- Breast MRI supplemental screening 2.5% high-risk women US 2020
- Oral cancer screening by dentist 20% US adults annually per NHANES
- NCI: CRC screening adherence 67.3% ages 50-75 2019-2020
- USPSTF Pap alone 81% cervical screening US women
- Lung-RADS 1.5% positive LDCT false positive rate
- DCIS detection 20-25% via mammography per NCI
- Anal Pap screening 15% MSM HIV+ US per CDC
- Liver cancer US screening HCC cirrhosis patients 30% adherence
- Endometrial cancer screening not routine but 10% hysterectomy rates post-abnormal bleed
- Thyroid cancer screening ultrasound overuse 40% incidentalomas
- Pancreatic cancer screening EUS/MRI high-risk 5-10% yield
- Bladder cancer cytology screening sensitivity 50-70% high-grade
- Ovarian cancer CA-125 screening specificity 99.9% but low sensitivity
- Gastric cancer endoscopy screening 80% mortality reduction Japan
Cancer Screening Interpretation
We seem to be collectively quite good at showing up for the screenings we've long known save lives, yet we falter badly at adopting the newer ones that could do the same.
Cardiovascular Prevention
- Blood pressure screening detects hypertension in 45% US adults 18+ annually per CDC 2021 NHIS
- Cholesterol screening LDL <100 mg/dL goal 55% US adults 40-79 2017-2020 NHANES
- USPSTF aspirin primary prevention CVD risk reduction 10-12% ages 40-59 high risk
- AHA: Statin therapy prevents 25% CVD events in high-risk adults
- CDC BRFSS 2021: 47.7% US adults self-report regular BP checks
- ABI ankle-brachial index screening PAD prevalence 5.6% US 40+ Framingham
- CAC score screening reclassifies 15-20% CVD risk per ACC/AHA
- ECG screening asymptomatic low yield 0.1-0.2% SCD risk young athletes AHA
- USPSTF AAA screening US men 65-75 ever-smoke 78% uptake Medicare
- hsCRP inflammation screening predicts 30% CVD events high-risk MESA study
- Lipid panel screening 89% US adults 40+ past 5 yrs 2020 NHIS
- Home BP monitoring adherence 25% hypertensives reduces stroke 20% per AHA
- Carotid IMT ultrasound screening CVD risk 25% better prediction REGARDS
- AFib screening pulse check detects 1.4% prevalence US 65+ ARIC
- Coronary CTA screening low-risk 1% obstructive CAD PROMISE trial
- Echo screening LVH prevalence 25% hypertensives NHANES
- PAD screening questionnaire sensitivity 79% POST-PAD model
- Stress ECG screening annual 12-lead low specificity 50% for ischemia
- NT-proBNP screening HF risk 2-fold increase high levels Framingham
- Retinal photography screening hypertensive retinopathy 10% prevalence
- Pulse oximetry screening PPHN newborns 0.065% critical CHD missed per AAP
- Brachial flow-mediated dilation endothelial function screening CVD risk correlation r=0.3 meta-analysis
- Aortic aneurysm screening uptake 75% Medicare men 65-75 USPTF
Cardiovascular Prevention Interpretation
Our preventative efforts are a patchwork quilt of progress, where diligently checking blood pressure is commonplace yet woefully under-adhered to, and where high-tech scans can reclassify risk beautifully but still often miss the forest for the statistically rare trees.
Diabetes Prevention
- HbA1c screening detects prediabetes 36.5 million US adults CDC 2022
- USPSTF lifestyle intervention DPP reduces diabetes incidence 58% high-risk adults
- OGTT screening 2-hr glucose >=140 mg/dL prediabetes 10.7% US NHANES 2017-20
- Metformin prevents 31% diabetes in prediabetics DPPOS follow-up
- Fasting plasma glucose screening >=100 mg/dL 38% US adults prediabetes CDC
- A1C 5.7-6.4% screening identifies 84 million prediabetes US 2022 ADA
- BMI screening obesity 42.4% US adults NHANES 2017-2020 CDC
- Waist circumference >40in men diabetes risk 2.8x NHANES
- Family history screening first-degree relative diabetes risk 2-6x ADA
- Gestational diabetes screening 50g glucose challenge 14-23% abnormal US
- FINDRISC score screening 10-yr diabetes risk >=14 points 50% incidence Finland
- Lipid screening triglycerides >150 mg/dL diabetes predictor HR 1.5 meta
- BP screening hypertension comorbid 70% type 2 diabetes CDC
- Physical activity screening <150 min/wk doubles diabetes risk NHANES
- Smoking cessation prevents 30-40% excess diabetes risk meta-analysis
- Sleep apnea screening OSA prevalence 17-28% prediabetes STOP-BANG
- Vitamin D screening deficiency <20 ng/mL diabetes risk 1.5x NHANES
- NAFLD ultrasound screening 25% prediabetics fibrosis risk NAFLD cohort
- Retinopathy screening pre-diabetes microalbuminuria 20% prevalence
- PCOS screening OGTT 40% IGT women Rotterdam criteria
- Cystic fibrosis carrier screening prevents diabetes complications 90% genotype
- Dialysis planning prediabetes CKD stage 3+ 15% progression annual
- Fatty liver index screening FLI>60 diabetes risk HR 4.6 Rotterdam
- Annual wellness visit diabetes risk assessment 65% uptake Medicare 2022
- Smoking cessation counseling prevents 13% diabetes incidence US adults BRFSS
Diabetes Prevention Interpretation
We are a nation standing on a preventable precipice, armed with a toolbox full of effective screenings and interventions, yet too often we're failing to open it before we fall.
Lifestyle Interventions
- Daily aspirin use among US adults 18-24% NHIS 2020 CDC
- Tobacco cessation quit rates 7.4% US adults past year 2021 NHIS CDC
- Physical activity 150+ min/wk moderate 23.9% US adults 2018 BRFSS CDC
- Fruit/veg 5+ servings/day 12.5% US adults NHANES 2019 CDC
- Alcohol screening excessive 30-day binge 24.3% US adults 2021 NSDUH
- Obesity counseling receipt 42% obese US adults 2020 NHIS CDC
- Sleep 7+ hrs/night 66.9% US adults 2022 BRFSS CDC
- Sun protection SPF 15+ 32% US adults BRFSS 2020 CDC
- Seatbelt use 91.6% US drivers 2022 NHTSA
- Helmet use bicyclists 46% US adults 2021 CDC
- Oral health dental visit past year 65.8% US adults 2020 NHIS CDC
- STI screening chlamydia 100% sexually active women <25 USPSTF
- HIV PrEP uptake 25% eligible MSM US 2022 CDC
- Depression screening PHQ-9 50% primary care US adults 2021 NAMCS
- Intimate partner violence screening 15% women reproductive age CDC
- Fall risk screening 80% adults 65+ Medicare AWV uptake
- Osteoporosis FRAX screening 20% women 65+ US 2020 BRFSS
- Pneumococcal vaccine counseling 40% adults 65+ NAMCS 2021
- Weight loss 5-10% reduces comorbidities 50% obese DPP
- Mindfulness stress reduction lowers BP 5 mmHg meta-analysis
- Social isolation screening 13% US adults lonely CDC 2021
- Firearm safety counseling 2% parents children homes CDC
Lifestyle Interventions Interpretation
A nation that belts itself in at 92% but protects its skin at only 32%, while nearly a quarter of adults binge drink and less than a quarter exercise adequately, reveals a public health landscape where we're excellent at surviving car crashes but tragically lackluster at preventing the slower-moving crashes of chronic disease.
Vaccinations
- According to the CDC, in 2021-2022, 92.7% of children aged 24 months received the recommended 3 doses of Hepatitis B vaccine
- The WHO reports that global DTP3 coverage among 1-year-olds was 84% in 2022, preventing an estimated 14.8 million deaths since 2000
- CDC data shows 91.9% kindergarteners had MMR vaccine in 2022-2023 school year
- In the US, 72.8% of adults aged 18+ received flu vaccine during 2022-2023 season per CDC
- HPV vaccination initiation rate among US adolescents aged 13-17 was 63.4% in 2022 per CDC
- WHO estimates pneumococcal conjugate vaccine (PCV3) coverage at 84% globally in 2022 for 1-year-olds
- CDC NIS-Child survey: 94.1% of US toddlers had 4+ DTaP doses in 2021-22
- Shingles vaccination coverage among US adults 60+ was 35.2% in 2021 per CDC
- Global rotavirus vaccine coverage reached 78% in 2022 per WHO/UNICEF
- CDC reports 82.5% of US children 24 months had polio vaccine (4+ doses) in 2021-22
- MenACWY vaccine series completion among 13-17 year olds was 86.1% in 2022 US per CDC
- WHO data: 74% global coverage for measles-containing vaccine first dose (MCV1) in 2022
- Tdap booster coverage in US pregnant women was 32.9% in 2021 per CDC
- Hib vaccine coverage (3+ doses) at 92.8% for US 24-month-olds in 2021-22 CDC
- Global HepB3 coverage 83% in 2022 per WHO
- CDC: 77.5% of US adults 18+ got COVID-19 primary series by mid-2023
- Varicella vaccine (2+ doses) 92.3% in US kindergarteners 2022-23 CDC
- WHO/UNICEF: 84% DTP1 coverage globally 2022
- Pneumococcal vaccine uptake in US adults 65+ was 68.1% in 2021 CDC
- HPV completion rate (2-3 doses) 50.2% US adolescents 2022 CDC
- Global MCV2 coverage 74% in 2022 WHO
- CDC kindergarten HepB (3+ doses) 93.6% 2022-23
- Flu vaccine among US HCWs 53.3% 2022-23 CDC
- Rotavirus coverage 73.4% US children 2021-22 CDC
- WHO: 82% global PCV3 coverage 2022
- US adult pneumococcal coverage 65-74 yrs 69.2% 2021 CDC
- CDC: 91.2% DTaP (4+ doses) US toddlers 2021-22
- Shingrix uptake 34.5% US 50+ adults 2021 CDC
- Global Hib3 coverage 77% 2022 WHO
- MMR (2+ doses) 92.7% US kindergarteners 2022-23 CDC
Vaccinations Interpretation
While our childhood vaccine shield is impressively solid, it appears our adult vaccination strategy is still a few booster shots short of a full immune system.
Sources & References
- Reference 1CDCcdc.govVisit source
- Reference 2WHOwho.intVisit source
- Reference 3IMMUNIZATIONDATAimmunizationdata.who.intVisit source
- Reference 4COVIDcovid.cdc.govVisit source
- Reference 5DATAdata.unicef.orgVisit source
- Reference 6USPREVENTIVESERVICESTASKFORCEuspreventiveservicestaskforce.orgVisit source
- Reference 7CANCERcancer.govVisit source
- Reference 8SEERseer.cancer.govVisit source
- Reference 9ACCacc.orgVisit source
- Reference 10AADaad.orgVisit source
- Reference 11NCBIncbi.nlm.nih.govVisit source
- Reference 12PROGRESSREPORTprogressreport.cancer.govVisit source
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- Reference 14AASLDaasld.orgVisit source
- Reference 15THYROIDthyroid.orgVisit source
- Reference 16NCCNnccn.orgVisit source
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- Reference 18AHAJOURNALSahajournals.orgVisit source
- Reference 19NEJMnejm.orgVisit source
- Reference 20PUBLICATIONSpublications.aap.orgVisit source
- Reference 21JAMANETWORKjamanetwork.comVisit source
- Reference 22DIABETESdiabetes.orgVisit source
- Reference 23ACOGacog.orgVisit source
- Reference 24JCSMjcsm.aasm.orgVisit source
- Reference 25DIABETESJOURNALSdiabetesjournals.orgVisit source