Rapid review
Primary prevention and screening in the health services
Report
|Updated
Key message
We have summarily gone through a selection of systematic reviews of interventions for the primary prevention of a number of diseases, as well as interventions aimed at reducing risk factors for disease. Based on the conclusions in these systematic reviews, the following interventions seem to work:
Cancer ● screening for breast cancer with mammography ● chemoprevention with tamoxifen in women with high risk for breast cancer ● screening for colorectal cancer using faecal occult blood testing or sigmoidoscopy ● screening for cervical cancer in women who have been sexually active (and who have a cervix) ● vaccines against human papillomavirus ● chemoprevention with 5ARI for prostate cancer
Diabetes ● physical activity in combination with diet in persons with a high risk of diabetes (impaired glucose tolerance or the metabolic syndrome) ● weight loss using dietary, physical activity or behavioural interventions in persons with prediabetes
Mental health ● screening for depression in adults ● lithium for prevention of suicide in persons with mood disturbance Alcohol use ● repeated brief consultations, up to four visits, in primary health care (the documentation is more convincing for men than for women)
Physical inactivity ● advice given together with written materials and followed up by telephone ● advice related to high intensity and frequency as compared to low intensity and frequency
Overweight or obesity ● diet based on low glycaemic index or low glycaemic load ● pharmacological treatment ● pharmacological treatment in persons with type 2 diabetes ● physical exercise, especially in combination with diet ● a combination of behavioural therapy, diet, and physical activity for children, targeting the family ● psychological interventions (behavioural or cognitive behavioural approaches), especially in combination with diet and physical activity ● screening and intensive behavioural counselling to promote weight loss in obese adults
Tobacco use ● screening and counselling for smoking cessation in adults, including pregnant women ● advice from health care personnel ● group therapy ● individual advice ● telephone counselling, several calls ● nicotine replacement therapy ● medication ● a combination of counselling and medication