Routine Screening for Women

Screening for women is directed at early detection of cancer of the breast and cervix, and osteoporosis.

Screening for cancer of the cervix

Cancer of the cervix is relatively common and is easily detected through routine screening, which is a Pap test (looks at cells on the cervix) and a test for HPV (Human Papilloma Virus, a common cause for cancer of the cervix).  The physician removes a sampling of superficial cells during an internal exam which are examined microscopically for any cancerous changes.

Pap tests should be done annually in women after age 21 or the onset sexual intercourse.  If testing is negative for several years, then it may be safe to screen less often.


Screening for breast cancer

Breast cancer is relatively common and should be screened for aggressively, since it is most treatable when found early. 

Breast self exam should be done in women monthly (after the period is over) after age 25.

Doctor breast exam is typically done at the time of a Pap test, i.e. annually.

When to begin screening with mammograms (a special x-ray of the breast) is somewhat controversial, though most authorities would agree that a baseline should be done at age 35, every 1-2 years from age 40-50, and annually after age 50.  Special emphasis is placed on screening women with a family history of breast cancer (mother or sister).  It may be reasonable to stop doing mammograms after age 75. 

There are medications which may be given to high risk women which appear to reduce the likelihood of developing breast cancer (Tamoxifen and Evista).


Screening and prevention of osteoporosis

Osteoporosis is defined as the thinning of bones that naturally occurs after menopause.  This is typically asymptomatic, but can predispose towards fractures. 

Osteoporosis is diagnosed by a specialized x-ray called a bone density or DEXA scan. 

Prevention is begun early in life with adequate calcium, either through the diet or with supplements.  A pre-menopausal women should have at least 1000 mg of calcium per day and a post-menopausal women at least 1500 mg per day.  Vitamin D 1000 units a day should also be added.

Weight bearing exercise has also been shown to strengthen bones and reduce the chance of fracture.

If osteoporosis is found, there are prescription medications that can reverse this process.    



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