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Preventive medicine can be categorized as primary, secondary, or tertiary. Primary prevention aims to remove or reduce disease risk factors (eg, immunization, giving up or not starting smoking). Secondary prevention techniques promote early detection of disease or precursor states (eg, routine cervical Papanicolaou screening to detect carcinoma or dysplasia of the cervix). Tertiary prevention measures are aimed at limiting the impact of established disease (eg, partial mastectomy and radiation therapy to remove and control localized breast cancer).

Tables 1–1 and 1–2 give leading causes of death in the United States and estimates of deaths from preventable causes. Recent data suggest increased rates of death, mainly from suicide and substance misuse. Unintentional injuries, including deaths from opioid-related overdoses, have become the third leading cause of death in the United States.

Table 1–1.Leading causes of death in the United States, 2016.
Table 1–2.Deaths from all causes attributable to common preventable risk factors. (Numbers given in the thousands.)

Many effective preventive services are underutilized, and few adults receive all of the most strongly recommended services. Several methods, including the use of provider or patient reminder systems (including interactive patient health records), reorganization of care environments, and possibly provision of financial incentives to clinicians ...

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