Published in the April issue of I, the timetable groups the periodic health assessments by age range beginning at age 13, and takes into account individual risk factors that may warrant additional screenings or counseling.
“The purpose of the annual ob-gyn visit is to detect and treat any new or ongoing health problems as well as to help prevent future ones from developing,” said Hal C. Lawrence, III, MD, vice president for Practice Activities at The College. “The College urges the US Department of Health and Human Services to include these screenings, tests, and immunizations included in our well-woman exam recommendations under the preventive services that it is considering for inclusion under the new health care law.”
The revised schedule covers the long-standing staples of the well-woman exam. No matter a woman’s age, there are standard components of the annual ob-gyn exam, including assessing current health status, nutrition, physical activity, sexual practices, and tobacco, alcohol, and drug use. Across age groups, the standard physical exam also includes height, weight, body mass index (BMI), and blood pressure. Annual breast and abdominal exams begin at age 19, and routine annual pelvic exams begin at age 21.
“Since the age a woman receives her first Pap test changed two years ago to age 21, and most women can have them less frequently than previously recommended, there’s this misconception that if you don’t need a Pap then you can skip the ob-gyn visit altogether,” said Dr. Lawrence. “Nearly every woman age 21 and older needs an annual well-woman visit with her ob-gyn, regardless of whether cervical cancer screening is done. The Pap test is just one part of staying healthy.”
Information is included regarding which vaccinations are recommended, by age and risk group, including the flu shot, Hepatitis A and B, human papillomavirus (HPV), and measles. Annual testing for chlamydia and gonorrhea is recommended for all sexually active adolescents and young women up to age 25. Routine HIV testing is recommended for all sexually active adolescents and women beginning at age 19 until age 64.
The College’s recommendations serve as guidelines for ob-gyns and others who provide health care to women, and they should be modified as necessary to meet an individual patient’s needs. Some women may have certain high-risk factors or conditions that may require additional or more frequent tests and interventions. “For instance, we recommend that women have their first mammogram at age 40, and yearly beginning at 50, but a woman and her doctor may decide to have a baseline mammogram before age 40 if there is a family history of breast cancer,” said Dr. Lawrence.
Committee Opinion #483, “Primary and Preventive Care: Periodic Assessments,” is published in the April 2011 issue of Obstetrics & Gynecology.
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The American College of Obstetricians and Gynecologists (www.acog.org) is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 55,000 members, The American College of Obstetricians and Gynecologists strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. Follow us on Twitter at www.twitter.com/acognews.
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