Discuss patient medical or family history that may alter your recommendation for screening?

Discussion.

From the U.S. Preventive Task Force website https://www.uspreventiveservicestaskforce.org/BrowseRec/Index (Links to an external site.)Links to an external site., choose one screening test that might be considered in primary care.

Define the test, its positive predictive value, reliability and validity. Discuss patient medical or family history that may alter your recommendation for screening?

Direct Quotes

Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.

Sample

One screening test that might be considered in primary care is cervical cancer screening. Cervical cancer is a leading cause of cancer deaths among women worldwide, however, the number of cases and number of deaths in the United States have decreased drastically. In 2014, 12,578 women were diagnosed and 4,115 women have died from cervical cancer (Centers for Disease Control and Prevention [CDC], 2017). It is commonly diagnosed and is one of the most successfully treated cancers.

Cervical cancer screening is an essential part of a woman’s routine health checkup. Cytology screening or papanicolaou (Pap) test and the human papillomavirus (HPV) test are used for early detection of cervical cancer. Pap test is used to detect abnormal cervical cells including precancerous lesions before developing into cancer or cancer itself. It can also detect other conditions such as infections and inflammation. The HPV test is used to detect the virus in cervical cells that may have changed (CDC, 2017). The U.S. Preventive Services Task Force (USPSTF) recommends women ages 21-29 to screen for cervical cancer using cytology every 3 years. For women ages 30-65 a combination of cytology and HPV testing is recommended every 5 years (Hofmeister, 2016).

Positive predictive value is the probability of patients who test positive who have the disease (Gordis, 2014). According to Gordis (2014), validity determines between who has a disease and who does not have a disease. Sensitivity and specificity are two elements within validity. Sensitivity tests to identify those who have the disease and specificity tests to identify those who do not have the disease (Gordis, 2014). Reliability refers to consistency. For example, a test that is repeated more than once resulting with the same or similar results.

Patient history may alter recommending cervical cancer screening more than family history because it is mostly sexually transmitted. Women who have a compromised immune system, who have human immunodeficiency virus (HIV) infection, who have had prior abnormal results, who have been exposed to diethylstilbestrol (DES) in utero, who have a hysterectomy, and who have had previous treatment of a high-grade precancerous lesion are at an increased risk for cervical cancer (Hofmeister, 2016). Cervical cancer screening should be provided to all women in a primary care setting. It is a preventable disease with the effectiveness of early detection and early treatment.

Reference

Centers for Disease Control and Prevention. (2017). Cervical cancer statistics. Retrieved from https://www.cdc.gov/cancer/cervical/statistics/index.htm (Links to an external site.)Links to an external site.

Gordis, L. (2014). Epidemiology (5th ed.). Philadelphia, PA: Elsevier Saunders.

Hofmeister, S. (2016). Cervical cancer screening: How our approach may change. Journal of Family Practice, 65(8). 551-553.

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