Wellness and Prevention


 

Well woman examinations

  • Annual check ups to discuss disease prevention (includes breast and gynecologic examinations).
  • Pap smear and HPV testing may be performed at this time.
  • Opportunity to bring up any gynecological or breast issues that need to be addressed.  A follow up appointment will be made to discuss these issues in detail.

Cervical cancer screening

  • Pap smear is a test used to screen for cervical cancer in someone who has no symptoms, i.e. abnormal bleeding, vaginal discharge, or pain, or any physical findings that may suggest the presence of cervical cancer.
  • HPV (human papilloma virus) testing is tested along with the Pap smear test in women older than age 30 to allow earlier detection of cervical cancer or pre-cancerous changes.  It may be performed in women younger than 30 years of age if the Pap smear results are abnormal.
  • Pap smear is no longer done on a yearly basis.  The frequency of your testing will be based on an individual basis.  Your doctor will discuss the optimal timing of testing during your well woman exam.
  • Cervical cancer screening may be discontinued at the age of 65 if previous screening tests have been normal.  Your doctor will discuss with you the timing to exit the Pap/HPV testing.

Breast cancer screening

  • Mammography is a test to screen for breast cancer in women greater than 40-50 years of age.
  • Mammography may be performed earlier in someone with a family history of breast cancer.
  • Your doctor will discuss the optimal age to start mammography and how frequent this should be done on an individual basis during your well woman exam.
  • Breast ultrasound may be required to provide more information and will be determined by your OBGYN and by the radiologist.
  • In certain patients who are high risk for hereditary breast cancer, genetics screening may be considered.  Breast MRI may also be recommended by your doctor.
  • Breast cancer screening should continue if you are in good health.  There is no optimal time to stop screening.  Talk to your doctor during your well woman exam about timing to exit screening.

Osteoporosis screening

  • Bone density screening using the DEXA (Dual Energy X Ray Absorptiometry) scan is used to diagnose osteoporosis and bone mineral density (BMD) screening should start at age 65 for all women.
  • Postmenopausal women younger than 65 should start screening if they have significant risk factors for osteoporosis or bone fracture.
  • If nothing has changed, DEXA should not be performed more often than every 2 years.
  • The Institute of Medicine (IOM) recommends daily calcium:
    • Girls ages 9-18: 1,300 IU/day
    • Women ages 19-50: 1,000 IU/day
    • Women ages > 50: 1,200 IU/day
  • The IOM recommends daily vitamin D:
    • 600 IU/day for most women
    • 800 IU/day for women age > 70 years

Colon cancer screening

  • The Center for Disease Control and Prevention (CDC) recommends regular screening for colorectal cancer starting at age 50 years and continuing until age 75 years.
  • Screening should begin earlier for patients at higher risk for developing colorectal cancer.

There are different methods of screening  (high-sensitivity fecal occult blood test or FOBT, flexible sigmoidoscopy, or colonoscopy) and should be discussed with your gastroenterologist.

Genetics carrier screening

  • Pregnancy planning: if you are planning to conceive, your doctor may recommend screening for certain diseases that may affect your future offspring.  If you are a carrier, your partner should also be tested to determine the chance your future offspring will be affected by the disorder.  Your doctor will refer you to a genetics counselor for further counseling if your test comes back abnormal.
  • Strong family history of genetic disorders or familial cancer syndrome: These are tests that help identify individuals at risk for developing certain cancers that run in the family.  If identified, you may benefit from more frequent screening for disease development as well as early prevention of disease.

Vaccination

  • HPV vaccine
  • Annual Influenza vaccine
  • Tdap
  • Hepatitis A
  • Hepatitis B
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