US Preventive Services Task Force T he US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms.It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Summary of Recommendations and EvidenceThe USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation) (Figure 1).The risks and benefits of different screening methods vary. See the Clinical Considerations section later in this article and the Table for details about screening strategies.The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history (C recommendation).• Adults in this age group who have never been screened for colorectal cancer are more likely to benefit. IMPORTANCE Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134 000 persons will be diagnosed with the disease, and about 49 000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 73 years. OBJECTIVE To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer. EVIDENCE REVIEWThe USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. The USPSTF also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods.FINDINGS The USPSTF concludes with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no empirica...

heUSPreventiveServicesTaskForce(USPSTF)makesrecommendationsabouttheeffectivenessofspecificpreventivecare services for patients without related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Summary of Recommendation and EvidenceThe USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (B recommendation) (Figure 1) Rationale Importance Depression is among the leading causes of disability in persons 15 years and older. It affects individuals, families, businesses, and so-DESCRIPTION Update of the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for depression in adults. METHODSThe USPSTF reviewed the evidence on the benefits and harms of screening for depression in adult populations, including older adults and pregnant and postpartum women; the accuracy of depression screening instruments; and the benefits and harms of depression treatment in these populations.POPULATION This recommendation applies to adults 18 years and older.RECOMMENDATION The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (B recommendation)

A thin glacial diamicton, informally termed Granite drift, occupies the floor of central Beacon Valley in southern Victoria Land, Antarctica. This drift is Ͻ1.0 m thick and rests with sharp planar contacts on stagnant glacier ice reportedly of Miocene age, older than 8.1 Ma. The age of the ice is based on 40 Ar/ 39 Ar analyses of presumed in situ ash-fall deposits that occur within Granite drift. At odds with the great age of this ice are high-centered polygons that cut Granite drift. If polygon development has reworked and retransported ash-fall deposits, then they are untenable as chronostratigraphic markers and cannot be used to place a minimum age on the underlying glacier ice.Our results show that the surface of Granite drift is stable at polygon centers and that enclosed ash-fall deposits can be used to define the age of underlying glacier ice. In our model for patternedground development, active regions lie only above polygon troughs, where enhanced sublimation of underlying ice outlines high-centered polygons. The rate of sublimation is influenced by the development of porous gravel-and-cobble lag deposits that form above thermal-contraction cracks in the underlying ice. A negative feed-*back associated with the development of secondary-ice lenses at the base of polygon troughs prevents runaway ice loss. Secondaryice lenses contrast markedly with glacial ice by lying on a ␦D versus ␦ 18 O slope of 5 rather than a precipitation slope of 8 and by possessing a strongly negative deuterium excess. The latter indicates that secondary-ice lenses likely formed by melting, downward percolation, and subsequent refreezing of snow trapped preferentially in deep polygon troughs.The internal stratigraphy of Granite drift is related to the formation of surface polygons and surrounding troughs. The drift is composed of two facies: A nonweathered, matrix-supported diamicton that contains Ͼ25% striated clasts in the Ͼ16 mm fraction and a weathered, clast-supported diamicton with varnished and wind-faceted gravels and cobbles. The weathered facies is a coarsegrained lag of Granite drift that occurs at the base of polygon troughs and in lenses within the nonweathered facies. The concentration of cosmogenic 3 He in dolerite cobbles from two profiles through the nonweathered drift facies exhibits steadily decreasing values and shows the drift to have formed by sublimation of underlying ice. These profile patterns and the 3 He surface-exposure ages of 1.18 ؎ 0.08 Ma and 0.18 ؎ 0.01 Ma atop these profiles indicate that churning of clasts by cryoturbation has not occurred at these sites in at least the past 10 5 and 10 6 yr. drift is stable at polygon centers, low-frequency slump events occur at the margin of active polygons. Slumping, together with weathering of surface clasts, creates the large range of cosmogenic-nuclide surface-exposure ages observed for Granite drift. Maximum rates of sublimation near active thermal-contraction cracks, calculated by using the two 3 He depth profiles, range from 5 m/m.y. to 90 m/m.y. Sublimat...

The USPSTF recommends screening for high blood pressure in adults aged 18 years or older. (A recommendation) The USPSTF recommends obtaining measurements outside of the clinical setting for diagnostic confirmation before starting treatment.