How preventive care appears in the AKT
The AKT is 150 single-best-answer questions in a four-hour paper sitting. In the 2026.1 sitting, 1,117 candidates sat the exam and 80.6% passed, with a pass mark of 67.1% set by the modified Angoff method. The RACGP notes that questions can have between five and ten options, that more than one option may be plausible, and that you must choose the most appropriate one for the scenario.
Recent public exam reports list topics such as cervical screening, lung cancer screening, diabetes screening and immunisation in pregnancy. Preventive questions reward exact knowledge: the age a program starts, the interval, the test and who is excluded.
The Red Book
The RACGP Guidelines for preventive activities in general practice, the Red Book, is the core reference. The 10th edition (2024) moved to the GRADE approach, combined cardiovascular topics into one absolute risk chapter, and added topics including lung, bladder, pancreatic and thyroid cancer, developmental delay and autism, anxiety, eating disorders, gambling, perinatal mental health, frailty, and sleep.
Recommendations are graded, so exam questions often ask for the recommended action for a specific age and risk group, not a list of everything that could be done.
National screening programs
| Program | Who | Test and interval |
|---|---|---|
| Cervical | People with a cervix aged 25 to 74 who have ever been sexually active | HPV test every 5 years; self-collection available to everyone eligible |
| Bowel | Ages 45 to 74 | iFOBT every 2 years; kits mailed from 50, ages 45 to 49 can request |
| Breast | Women 50 to 74 invited; from 40 can attend | Mammogram every 2 years |
| Lung | Ages 50 to 70, smoking now or quit within 10 years, at least 30 pack-years, no symptoms | Low-dose CT, every 2 years if very low risk |
People at higher than average risk, such as those with a strong family history of bowel or breast cancer, follow different surveillance schedules. Screening programs are for people without symptoms; symptoms need diagnostic tests.
Cardiovascular and diabetes risk
- Use the AusCVDRisk calculator from 45 to 79 (35 with diabetes, 30 for Aboriginal and Torres Strait Islander people). Categories: high 10% or more, intermediate 5% to under 10%, low under 5% over 5 years.
- Do not use the calculator for people already at high risk, such as moderate to severe CKD or familial hypercholesterolaemia.
- Screen for type 2 diabetes with AUSDRISK from age 40 (earlier in higher-risk groups); test with HbA1c or fasting glucose if the score is 12 or more.
- Check blood pressure at least every 2 years in adults, and more often with risk factors.
Immunisation in adults and pregnancy
| Group | Recommended (check current NIP) |
|---|---|
| Pregnancy | Influenza at any stage; pertussis ideally 20 to 32 weeks of each pregnancy; RSV protection for the infant by maternal vaccine or infant immunisation |
| Adults 65 and over | Annual influenza; pneumococcal vaccine; shingles vaccine (recombinant) from 65 |
| Aboriginal and Torres Strait Islander adults | Earlier funded vaccines, including influenza from 6 months and pneumococcal and shingles at younger ages |
| Occupational and travel | Hepatitis B for healthcare workers; travel vaccines by itinerary |
National Immunisation Program funding and ages change; always check the Australian Immunisation Handbook.
Lifestyle interventions
- Smoking: ask, advise and help (the 5As); offer combination nicotine replacement, varenicline or bupropion, and Quitline referral. Nicotine vapes are available on prescription for smoking cessation in Australia.
- Alcohol: screen with AUDIT-C; NHMRC guidance is no more than 10 standard drinks a week and no more than 4 on any day.
- Physical activity: adults 150 to 300 minutes of moderate activity a week, plus strength training on 2 days.
- Weight: measure BMI and waist circumference and offer structured support.
- Falls: assess older people for falls risk, vision, medicines and home hazards.
MBS health checks that support prevention
- Aboriginal and Torres Strait Islander health assessment (item 715), once every 9 months.
- Health assessment for people aged 45 to 49 at risk of chronic disease.
- Annual health assessment for people aged 75 and over.
- Heart health check for adults at cardiovascular risk.
See Medicare and the MBS for IMGs and Australian screening in one table.
Worked examples
Worked example 1 · Cervical screening
A 27-year-old woman has her first cervical screening test. HPV (not 16/18) is detected and reflex liquid-based cytology is negative. What is the most appropriate next step?
- A Colposcopy within 8 weeks
- B Repeat HPV test in 12 months
- C Return to 5-yearly screening
- D Repeat the test in 6 weeks
- E Refer for a LLETZ
Show the reasoning
Answer B. Oncogenic HPV other than types 16 or 18 with negative or low-grade cytology is intermediate risk: repeat the HPV test in 12 months. HPV 16 or 18 would mean direct referral to colposcopy.
Worked example 2 · Bowel screening
A 46-year-old man with no symptoms and no family history asks about bowel cancer screening. What is the most appropriate advice?
- A Screening starts at 50, so wait
- B He can request an iFOBT kit now and repeat every 2 years
- C Arrange colonoscopy every 5 years
- D CT colonography every 10 years
- E Annual faecal occult blood test from 55
Show the reasoning
Answer B. Since July 2024, people aged 45 to 49 can request their first kit from the National Bowel Cancer Screening Program and are then sent a kit every 2 years. Colonoscopy is for symptoms, a positive screen or higher-risk people.
Common preventive care traps
- Ordering screening tests for symptomatic patients.
- Running the CVD calculator in someone already at high risk.
- Using annual Pap smears instead of 5-yearly HPV testing.
- Recommending PSA as population screening rather than an informed choice.
- Forgetting immunisation in pregnancy.
Free sample preventive care questions
Questions from our GP AKT bank. Choose your answer, then open the explanation.
A 47-year-old with no symptoms and no family history asks about bowel cancer screening. What is recommended?
- AAnnual CT colonography
- BColonoscopy every 5 years from 40
- CA 2-yearly iFOBT from age 45
- DFaecal occult blood test only if he has symptoms
- ENo screening until 60
Show answer and explanation
Answer C. The National Bowel Cancer Screening Program offers a free immunochemical faecal occult blood test (iFOBT) every 2 years for people aged 45 to 74 at average risk. Symptomatic people need diagnostic investigation, not screening.
Learning point: Bowel screening: iFOBT every 2 years, ages 45 to 74.
Which group is a priority for hepatitis B vaccination in Australia?
- AOnly health workers in Victoria
- BPeople who inject drugs
- CEveryone over 80 only
- DOnly after a needle-stick injury
- EOnly people born overseas
Show answer and explanation
Answer B. Hepatitis B vaccination is recommended for non-immune adults at increased risk, including people who inject drugs, household and sexual contacts of people with hepatitis B, men who have sex with men, healthcare workers and others. It is part of the infant schedule since 2000.
Learning point: Hep B vaccine for at-risk non-immune adults (PWID, contacts, MSM, health workers).
A 52-year-old woman at average risk asks about breast screening. What does BreastScreen Australia offer?
- ASelf-examination only
- BA mammogram every 2 years
- CUltrasound every year
- DAnnual breast MRI
- EMammography only after symptoms appear
Show answer and explanation
Answer B. BreastScreen Australia invites women aged 50 to 74 for a free screening mammogram every 2 years; women aged 40 to 49 and over 74 are eligible to attend. Higher-risk women may need different surveillance.
Learning point: BreastScreen: mammogram every 2 years for women 50 to 74.
Practise more preventive care questions free
Every preventive care subtopic in our bank
The bank holds 23 preventive care questions across 23 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Abdominal aortic aneurysm screening1
- Absolute CVD risk management1
- Alcohol guidelines1
- Bowel cancer screening1
- Breast screening1
- Diabetes screening1
- Falls prevention in older people1
- Familial bowel cancer risk1
- Hepatitis B vaccine adults1
- Hepatitis C cure1
- HIV prevention1
- Influenza vaccine in pregnancy1
- Lung cancer screening1
- Lung cancer screening eligibility1
- Overweight management1
- Pertussis vaccine in pregnancy1
- Physical activity for older adults1
- Physical activity guidelines1
- Pneumococcal vaccine in older adults1
- RSV in older adults1
- Shingles vaccine1
- Skin cancer checks1
- Skin cancer risk counselling1
Common questions
Which edition of the Red Book should I study for the AKT?
The current RACGP Red Book is the 10th edition, published in 2024. Check the RACGP website for any updates.
Does the AKT test screening intervals?
Yes. Preventive questions often depend on exact ages, intervals and tests for national programs.
Is PSA screening recommended in Australia?
Not as a population screening program. Men can choose testing after an informed discussion of benefits and harms.
When should CVD risk be assessed?
From 45 to 79 in the general population, from 35 with diabetes and from 30 in Aboriginal and Torres Strait Islander people.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.