الفهرس 
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Abstract
Prevention is better than cure‘ is an instinctive concept and its appeal is embedded in the medical and political culture.
Preventive healthcare is an important activity in general practice, it includes the prevention of illness, the early detection of specific disease, and the promotion and maintenance of health. Preventive care is based on a partnership between a Family physicians and a patient, designed to help each patient reach their goals of maintaining or improving health.
Prevention can be conducted through screening, counseling health education, chemoprevention and immunizations.
This work aims at helping family physicians to be competent self directed lifelong learners about evidence based medicine and the best evidence in the field of screening and prevention also to offer evidence based preventive care recommendation to individuals based on their risk factors in an unbiased competent way.
Because prevention involves an intervention in a patient who is a symptomatic, clinicians should demand a high standard of evidence for prevention strategies this is critical because all interventions including preventive screenings and immunizations have harms.
Evidence-based prevention recognizes that doing something to healthy asymptomatic individuals requires a good evidence base that the benefits of the intervention outweigh its harms.
Evidence based medicine is the integration of best research evidence with clinical expertise and patient values.
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The principles of EBM are rooted in the use of the best-possible study designs, large sample sizes, and the careful and unbiased interpretation of the best available evidence to support or oppose given medical treatments or interventions. However, although EBM may help to provide a fundamental framework for practitioners in the delivery of health care, it must be applied appropriately and be sensitive to the needs of individual patient.
Screening is testing for a health problem or risk factor when there are no recognized signs or symptoms that would indicate the presence of that problem or risk factor.
The primary purpose of screening tests is to detect early disease in apparently healthy individuals.
Family physicians should perform screening either when patients present for preventive care or opportunistically when patients present for other reasons. Proactive recall of patients for screening is warranted for high-risk groups or for conditions where population coverage has been identified by the government as a public health priority. These include immunization and screening for cervical, breast and colorectal cancers and diabetes.
It is important to approach prevention with a clear understanding of what health problem or adverse event to be prevented. Keep in mind that the goal of prevention is to help people live longer or have better quality of life, not merely to detect disease early.
It is recognized that not every health problem can be prevented. An important initial criterion for deciding whether a health problem should be included in routine preventive care is first burden of suffering caused by the problem Second there must be an
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effective and safe intervention that improves outcomes third criterion is cost-effectiveness. It is often assumed that prevention always saves the health care system money.
Family physicians should undertake opportunistic health promotion - the ordinary consultation can be used not just to treat the presenting problem, but also to manage ongoing problems, co-ordinate care with other health professionals, and undertake preventive health activities.
Intervention by Family physicians can have a significant effect on patients’ attitudes to a change to a healthier lifestyle. They must be supported by a caring doctor who follows the same guidelines and maintains a continuing interest. Examples include modifying diet, weight reduction, cessation of smoking, reduction of alcohol intake and undertaking exercise.
The USPSTF is an independent panel of prevention experts including family physicians, who conduct rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening ,counseling, and chemoprevention. Because of their rigor explicit methods, and impartiality, the USPSTF recommendations are considered by many to be the ―gold standard‖ for clinical preventive services. The USPSTF remains committed to evaluating evidence free from the influence of politics, special interests, and advocacy. Preventive services with a Task Force grade of A or B should be covered without cost-sharing (e.g., copayment or deductible) under new health insurance plans or policies. Its recommendations are widely accepted in the medical community. The USPSTF regularly updates its recommendations as new evidence accumulates. Its recommendations,
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systematic reviews, and evidence summaries are available at their website (http://www.ahrq.gov/CLINIC/uspstfix.htm).
The AAFP provides a Summary of Recommendations for Clinical Preventive Services (RCPS) that is periodically updated through the work of the AAFP‘s Commission on Health of the Public and Science (CHPS) and is approved by the AAFP Board of Directors. The starting point for the recommendations is the rigorous analysis of scientific knowledge available as presented by the United States Preventive Services Task Force. In most cases the AAFP agrees with the USPSTF, however, there are circumstances where there are differences.
The principles of EBM allow physicians to stay informed while also improving the quality of the information communicated to patients during patient encounters. The goal is always to provide the best care possible to patients—using one’s clinical expertise to address patient values and expectations for treatment.
Preventive activities are better introduced through a well established programms supported by governments.