Dr. Ron’s Research Review – July 29, 2015

©                                                                                                                 

This week’s research review focuses on the lab tests for the well woman visit.

The American Congress of Obstetricians and Gynecologists recommend the following lab tests. (ACOG, 2014)
Chlamydia, gonorrhea and HIV testing
Diabetes testing is recommended every 3 years after age 45 years.
Lipid profile assessment is recommended every 5 years beginning at age 45 years
Bone mineral density screening is recommended after age 65, no more frequently than every 2 years in the absence of new risk factors.
Urinalysis is recommended after age 65.
TSH is recommended every 5 years after age 65.

A recent article published in American Family Physician recommended the following for a health maintenance examination in women. (Riley et al., 2013)
High-risk sexually active women should be counseled on reducing the risk of STDs and screened for chlamydia, gonorrhea, and syphilis. All women should be screened for human immunodeficiency virus.
Adults should be screened for obesity and elevated blood pressure. Women over 20 should be screened for dyslipidemia if at increased risk of coronary heart disease. Those with sustained BP greater than 135/80 mm Hg should be screened for type 2 diabetes.
Colorectal cancer screening is recommend from 50-75 years of age.
Osteoporosis screening is recommended in women 65 years and older, and in younger women with a similar risk of fracture.

Dr. Ron


 

Articles

Health maintenance in women.
            (Riley et al., 2013) Download
The health maintenance examination is an opportunity to focus on disease prevention and health promotion. The patient history should include screening for tobacco use, alcohol misuse, intimate partner violence, and depression. Premenopausal women should receive preconception counseling and contraception as needed, and all women planning or capable of pregnancy should take 400 to 800 mcg of folic acid per day. High-risk sexually active women should be counseled on reducing the risk of sexually transmitted infections, and screened for chlamydia, gonorrhea, and syphilis. All women should be screened for human immunodeficiency virus. Adults should be screened for obesity and elevated blood pressure. Women 20 years and older should be screened for dyslipidemia if they are at increased risk of coronary heart disease. Those with sustained blood pressure greater than 135/80 mm Hg should be screened for type 2 diabetes mellitus. Women 55 to 79 years of age should take 75 mg of aspirin per day when the benefits of stroke reduction outweigh the increased risk of gastrointestinal hemorrhage. Women should begin cervical cancer screening by Papanicolaou test at 21 years of age, and if results have been normal, screening may be discontinued at 65 years of age or after total hysterectomy. Breast cancer screening with mammography may be considered in women 40 to 49 years of age based on patients' values, and potential benefits and harms. Mammography is recommended biennially in women 50 to 74 years of age. Women should be screened for colorectal cancer from 50 to 75 years of age. Osteoporosis screening is recommended in women 65 years and older, and in younger women with a similar risk of fracture. Adults should be immunized at recommended intervals according to guidelines from the Centers for Disease Control and Prevention.

 

References

ACOG. (2014). Well-Woman Recommendations. Retrieved from http://www.acog.org/About-ACOG/ACOG-Departments/Annual-Womens-Health-Care/Well-Woman-Recommendations
Riley, M, et al. (2013), ‘Health maintenance in women.’, Am Fam Physician, 87 (1), 30-37. PubMedID: 23317023