ACOG updates recommendations for wellness screening

The American College of Obstetricians and Gynecologists (ACOG) has updated its 2009 guidelines on recommended routine screenings, laboratory tests, and immunizations for nonpregnant adolescents and women.

In Committee Opinion No. 483, published in Obstetrics & Gynecology (2011;117[4]:1008-1015), the ACOG Committee on Gynecologic Practice recommended health assessments by age range and consideration of individual risk factors that may warrant additional screenings or counseling. The initial visit for screening, preventive care, and guidance, which doesn’t necessarily include an internal pelvic examination, should occur between 13 and 15 years of age. Annual breast and abdominal exams should begin at age 19, and routine annual pelvic exams and screening for cervical cancer should begin at age 21.

“Since the age a woman receives her first Pap test changed 2 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,” says Hal C Lawrence, III, MD, vice president for Practice Activities at ACOG. “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 1 part of staying healthy.”

The revised guidelines cover the standard components of the annual ob/gyn examination, including assessing current health status, nutrition, physical activity, sexual practices, and tobacco, alcohol, and drug use as well as height, weight, body mass index, and blood pressure. Annual testing for chlamydia and gonorrhea is recommended for all sexually active adolescents and young women up to age 25 as is routine testing for human immunodeficiency virus for sexually active adolescents and women between 19 and 64 years of age. Women should have an initial mammogram at 40 years of age and annual mammograms beginning at 50 years, unless they are at high risk for breast cancer. The guidelines also include information about recommended vaccinations by age and risk group for such diseases as influenza, hepatitis A and B, human papillomavirus, and measles.

ACOG has urged the US Department of Health and Human Services to include the recommended screenings, tests, and immunizations in the preventive services offered under the new health care law.