The Canadian Task Force on Preventive Health Care (CTFPHC) is composed of 15 experts who develop recommendations for clinical preventive services delivered by Canadian primary care practitioners. The CTFPHC is responsible for prioritizing the topics that will be reviewed, and works with the Prevention Guidelines Division of the Public Health Agency of Canada to define the analytic framework and scope of each topic. In the preparation of evidence reviews and the development of recommendations for each topic, the CTFPHC collaborates with the Evidence Review and Synthesis Centre and the Prevention Guidelines Division. The CTFPHC also leads knowledge translation and dissemination activities, and assists key stakeholders in designing and implementing an evaluation strategy to assess the impact of the guidelines.
Message from the Chair
Greetings! I am pleased to announce the release of two additional clinical practice guidelines: prostate cancer screening and adult obesity prevention and management.
On 27 October, 2014, CMAJ published the CTFPHC’s Recommendations on screening for prostate cancer with the prostate-specific antigen test. For more information about the prostate cancer guideline, systematic review and associated knowledge translation tools, please visit the CTFPHC prostate cancer guideline page.
On 26 January, 2015, CMAJ published the CTFPHC’s Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. For more information about the adult obesity guideline, systematic reviews and associated knowledge translation tools, please visit the CTFPHC adult obesity guideline page.
As always, we appreciate your interest in the work of the CTFPHC and we encourage you to stay up to date on our work by visiting the CTFPHC website.
Marcello Tonelli, MD SM
Screening for Prostate Cancer
In October 2014, CMAJ published the CTFPHC’s recommendations on screening for prostate cancer. Although prostate cancer is the third leading cause of cancer death for men in Canada, the majority of cases progress slowly and do not cause serious illness or death.
Evidence indicates that the harms of PSA screening outweigh the potential benefits. Many men experience false positive results, overdiagnosis and complications from prostate biopsies and surgeries following PSA screening. In addition, trials show that screening leads to only a small absolute risk reduction in prostate cancer mortality (i.e., 0.1%) and no reduction in overall mortality.
Based on the balance between the harms and benefits of screening, the CTFPHC made a strong recommendation against PSA screening in men under the age of 55, a weak recommendation against PSA screening in men aged 55–69, and a strong recommendation against PSA screening in men 70 years and older.
For further details, visit the CTFPHC prostate cancer guideline page.
Adult Obesity Prevention and Management
CMAJ published the CTFPHC’s recommendations on adult obesity prevention and management in January 2015. Over two thirds of Canadian men (67%) and more than half of Canadian women (54%) are overweight or obese. Furthermore, Canadians who are overweight or obese are at greater risk of developing a variety of chronic health conditions, such as cardiovascular diseases, type 2 diabetes, and cancers. Thus, it is important for primary care practitioners to have the most up-to-date evidence to support practice.
Because obesity often develops slowly in adulthood and weight is difficult to estimate, weighing patients is strongly recommended. Unfortunately, there is a lack of evidence that formal intervention programs for preventing obesity are effective. The CTFPHC’s weak recommendation for preventing obesity reflects these considerations.
Given that a large percentage of the Canadian population is already overweight and obese, the CTFPHC also developed recommendations for managing obesity in adults. These recommendations are based on a large body of clinical trial evidence. Notable is the strong recommendation that people at high risk of diabetes be offered formal behavioural programs to decrease the risk of progression to diabetes. The other recommendations are weak, reflecting consideration of the balance of benefits and harms of behavioural and pharmacological interventions.
For further details, visit the CTFPHC adult obesity guideline page.
Guidelines in Progress
Forthcoming guidelines developed by the CTFPHC will focus on the following topics:
- Child obesity prevention and management
- Screening for mild cognitive impairment
- Screening for colorectal cancer
- Screening for lung cancer
- Screening for developmental delay
- Screening for abdominal aortic aneurysm
- Screening for hepatitis C
- Tobacco prevention and cessation in children and adolescents
The CTFPHC always welcomes suggestions for guideline topics from members of the public and primary care practitioners. To submit a topic for consideration, please email firstname.lastname@example.org.
The CTFPHC has created a mobile app to help physicians rapidly access CTFPHC guidelines and resources at the point of care and while on the go. The app contains guideline and recommendation summaries, knowledge translation tools, and links to additional resources. Key features include the ability to bookmark sections for easy access, display content in either English or French, and change the font size of text. The app is available on iTunes (for iPhones and iPads) and Google Play (for Android devices).
The CTFPHC develops knowledge translation tools for members of the public and primary care practitioners to accompany each guideline. The purpose of the tools is to help clinicians and members of the public make decisions about preventive care.
Prostate Cancer Screening Resources
The CTFPHC developed five tools to accompany its prostate cancer screening guideline. The harms and benefits poster and infographic help physicians understand the balance between the harms and benefits of prostate cancer screening. The clinician FAQ answers questions that physicians may have about PSA screening and the patient FAQ is designed to help patients understand the advantages and disadvantages of undergoing PSA screening. Copies of the tools are available on the CTFPHC prostate cancer guideline page.
The CTFPHC also created a video about prostate cancer screening for primary care practitioners. This video provides key information about prostate cancer and PSA screening. To watch the video, please visit the CTFPHC prostate cancer guideline page or the CTFPHC YouTube channel.
Adult Obesity Prevention and Management Resources
To accompany its adult obesity prevention and management guideline, the CTFPHC developed an algorithm and FAQ sheet for clinicians. The clinician algorithm helps physicians identify which recommendations are relevant to a patient based on the patient’s body mass index. The clinician FAQ sheet answers questions that physicians may have about preventing and managing obesity in adults. Copies of the algorithm and FAQ sheet are available on the CTFPHC adult obesity guideline page.
As always, the CTFPHC encourages members of the public to discuss screening and management options with their primary care practitioner, who is aware of their health background and family history.