1.  Screening and Immunizations for Women Shannon Boerner, MD May 14, 2013

2. Objectives  Identify basic screening tests used in Women’s Health  Name common immunizations used in Women’s Health  Describe which tests are appropriate for you to ask your health care provider about

3. Screening Tests  Why?  Discover a disease or problem in its early, TREATABLE stages  Saves lives by finding diseases that would otherwise progress  Protects health  Communicable diseases

4. Pap Smear  What: screening for cervical cancer or precancerous cells  Who: all women who have a cervix  No Pap test for women who have had a hysterectomy (for non- cancerous reason)  When:  Start at age 21 (regardless of sexual activity)  Every 3 years until age 30  Between 30-65, every 5 years IF also having an HPV test  Stop after age 65  How: Pelvic exam with a speculum, small swab of cervix

5. Gonorrhea & Chlamydia  What: sexually transmitted infections  Who: all sexually active women 25 and younger  When: every year  How: swab of cervix during a speculum exam, or a urine test

6. HIV Test  What: sexually transmitted infection  Who: adults age 15 to 65, every pregnant woman  When:  at least once, or more often if risk factors continue  with every pregnancy, even if previously negative  How: blood test or cheek swab

7. Mammogram  What: breast cancer screening  Who: women age 40-50 to 75  When: every other year  How: X ray of breasts done with a machine that compresses (squeezes) the breast flat between two plates

8. DXA Scan  What: screening for osteoporosis (bone thinning)  Who: women over 65, or younger if you have risk factors  Smoking, Caucasian, thin, steroids, alcohol use, family history  When: Every 2-5 years, more often if you have osteoporosis  How: Lie down (fully dressed) on a DXA scanner

9. Colonoscopy  What: screening for colon cancer  Who: women age 50 to 75  Sooner if 1 st degree relative with colon cancer  When: every 10 years  How: flexible tube with camera passed through rectum into entire large intestine while you are sedated

10. Cholesterol Testing  What: screening for high cholesterol  Who: women age 20 to 65  When: every 5 years or less  Every 1-2 years if cholesterol is high  How: blood test – no longer need to be fasting

11. Diabetes Testing  What: screening for diabetes (high blood sugar)  Who: all adult women with BMI > 25 and one or more risk factors  Family history, gestational diabetes, physical inactivity, high blood pressure, high cholesterol, PCOS  When: Every year to 3 years  How: blood test – no longer have to be fasting

12. What Does She Need? Healthy 25 year old

13. Screening By Age  19 to 25 years  Screenings:  Pap (over age 21) every 3 years  Gonorrhea & chlamydia every year  HIV test at least once  Cholesterol testing (over age 20)  Diabetes testing (if risk factors present)

14. What Does She Need? Healthy 40 year old

15. Screening by Age  26 to 49 years  Screenings:  Pap (over age 30) every 5 years  HIV test at least once  Mammogram every other year over age 40  Cholesterol testing  Diabetes testing (if risk factors present)

16. What Does She Need? Healthy 55 year old

17. Screening by Age  50 to 75 years  Screenings:  Pap every 5 years  HIV test at least once  Mammogram every other year over age 40  Cholesterol testing  Diabetes testing (if risk factors present)  Colonoscopy at age 50 & every ten years

18. Immunizations  Vaccines save 3 million lives each year around the globe  Prevent disease and permanent disability in many millions more  Widely seen as the single greatest contributor to public health in the last century

19. DTaP  What: prevents diphtheria, tetanus, and pertussis  Who: adult women  When: age 19 and older  How: injection into muscle

20. Influenza  What: protects against influenza virus (“the flu”)  Who: all adult women  When: every year October through March  How: injection into muscle, nose spray, or dermal injection

21. HPV  What: protects against human papilloma virus (HPV) which causes cervical cancer  Who: all women age 19-26  When: anytime – series of 3 vaccines  How: injection into muscle

22. Pneumococcal  What: protects against many strains of pneumococcal bacterial infections  Pneumonia, ear infections, sinus infections, meningitis  Who: adult women 19-65 with risk factors  SMOKING, asthma, COPD, diabetes, liver disease  All adult women over 65  When: once  Unless given before 65 for risk factors, then once more after age 65  How: injection into muscle

23. Shingles  What: protects against shingles (herpes zoster)  Who: all adult women over 60  When: once  How: injection into muscle

24. What Does She Need? Healthy 25 year old

25. Immunizations by Age  19 to 59 years  DTaP once  Influenza every year  HPV series (until age 26)  Pneumococcal  if a smoker, lung disease, diabetes, etc

26. What Does She Need? Healthy 66 year old

27. Immunizations by Age  60 years and older  DTaP once  Influenza every year  Shingles once  Pneumococcal (over age 65)

28. Summary  Screenings and immunizations save lives and keep us healthier!  Ask your health care provider what screenings and vaccines are appropriate for you  Be educated  CDC (Centers for Disease Control) website is excellent & has clear, accurate info www.cdc.gov