WOMEN’SCANCERSCREENINGPROGRAM-KyCHFS.docVIP

MINIMAL REQUIREMENTS FOR A CANCER SCREENING VISIT ASSESSMENT INITIAL VISIT ANNUAL VISIT Comprehensive Health History to include: Family history of breast/genital/colon-rectal cancers LMP or date of menopause Contraceptive method if childbearing age Documentation of HRT or ERT if menopausal Date of last Pap/mammogram and results Previous abnormal Pap, diagnostics, treatments Previous breast problems, diagnostics, treatments Assessment for breast/cervical cancer risk factors Required (Health History and Physical Examination Form ) Required (Interval Health History and Physical Examination Form) Physical Examination to include: Documentation of general appearance and mental status Height/Weight/BMI Blood pressure Clinical breast examination (Using MammaCare? Technique) Pelvic examination that includes visualization of the vulva, vagina, cervix/vaginal cuff and thorough bimanual including adnexae Rectal exam (age 50 and as indicated for others) Other as needed Required Required Laboratory: Pap test (as indicated by age guidelines found later in this PHPR section) Required Required Fecal occult blood testing (ages 50 and older) 3 kits given with instructions If positive, refer to M.D. Required Required Hemoglobin If indicated If indicated STD testing If indicated by history/exam If indicated by history/exam Referral for annual mammogram (age 40) Required Required Counseling: (Documentation in medical record required) - ACH-40 (“Improving Health for Women”) – CSEM given/counseled and patient verbalized understanding Monthly BSE/Annual CBE Pap/Mammogram rescreening recommendations Regular exercise Adequate diet (low fat, high fiber, 5 fruits/vegetables daily) Osteoporosis/prevention and bone density testing Risks/Benefits of HRT if menopausal Contraception if needed Smoking risks/cessation and referral Immunization needs/update STD risk counseling if indicated Ovarian Cancer Screening at age 50 (age 25 if family history) (Locations: UKMC; Hardin