The client is aged 50 years and is a female with an unknown female history. The patient suffers from hypertension, but the blood pressure is under control presently through her use of lisinopril. She has not smoked for the past three years, with her smoking history being fifteen packs per day. She exercises moderately three to four days per week. This paper will review cholesterol and film mammography screening recommended by the United States Preventive Services Task Force (USPSTF, 2012).

Cholesterol Screening

Cholesterol in the body causes lipid disorders. As a healthcare professional a lipid screening is recommended for this patient. Among women candidates aged 45 years and above and men aged 35 years and above, with an increased risk of coronary heart disease, the USPSTF (2012) strongly recommends the lipid disorder screening and gives it an A grade. The USPSTF recommends lipid screening for men between 20 and 35 years and females aged between 20 and 45, who are vulnerable to coronary heart diseases. The USPSTF (2018) grades the screening grade B for this population. The USPSTF does not recommend for or against the screening for men aged between 20 years and 35 and women aged 20 years and older. It grades the screening of this population grade C (USPTSF, 2018). Grades A and B mean that this screening service can be provided to all adult patients aged above 20 years with the risk of coronary heart disease. Grade C implies that lipid disorder screening should be provided to men and women aged 20 years and older, depending on their health characteristics or the circumstances.

The USPSTF (2012) has established that lipid disorder screening for men aged 35, and above and women aged 45 and above, at increased risk for coronary heart diseases, the benefits substantially outweigh the potential ills. This translates to good-quality evidence. Good-quality evidence means that the evidence of the screening has generated consistent results from representative studies conducted in the population that asses the effects of the test on health outcomes (USPTF, 2018). There is fair-quality evidence for men between 20 and 35 years and women aged between 20 and 45 who are at increased risk for coronary heart disease. Fair-quality evidence means that the evidence is of moderate strength in determining the health outcomes of the screening or evidence that may not be consistent for individuals in past studies (USPTF, 2018). There is poor-quality evidence for the screening for men between 20 and 35 years and women aged 20 years and older. Poor-quality evidence means that the evidence available is insufficient to assess the health outcomes of the lipid disorder test for the participants (USPTF), 2018).

The risk assessment of the patient involves risk factors of coronary heart diseases, including diabetes, family history of cardiovascular diseases, tobacco use, hypertension, and body mass index. Although the patient’s history and body mass index are unknown, the patient has hypertension and has a history of tobacco use. Thus, the information is sufficient to recommend the patient to the lipid disorder screening. Lipid disorder screening has enormous benefits than risks for the patient as she is older than 45 years and has an increased risk of coronary heart diseases from tobacco use. The screening test involves measuring the serum lipid level in fasting or non-fasting samples. A five-year strategic interval screening is appropriate for tests (USPTF, 2012).

Healthline provides information on cholesterol screening. The screening is recommended for persons with a family history of heart diseases, are overweight, alcohol and cigarette use, inactive lifestyles, diabetes, and kidney disorders. The test involved blood analysis. Blood is drawn, preferably early morning after overnight fasting (Healthline, 2020).

The Mayo Clinic describes cholesterol tests as a blood test that measures cholesterol and triglycerides. The data needed from patients include family history, clients weight, lifestyle, history of diabetes, dietary information, and tobacco use, (Mayo Clinic, 2020). The Mayo Clinic (2020) also recommends testing for people aged 45 years and above for men and women aged 55 years and above. Contrary, Healthline (2020) recommends testing for people aged over 35 in men and 45 in females.

Film Mammography Screening

According to the United States Preventive Services Task Force (2012), woman between the ages of 50-74 years old are recommended to receive a film mammogram every two years.  USPSTF (2012) categorized and mammograms for women ages 50-74 as grade B. Grade B is considered moderately valuable and beneficial for client screening (USPSTF, 2018). In the clinical setting providers are recommended to practice using Grade B when providing screening to this particular population. There have been enough sufficient studies to indicate that there is a moderate level of reliability to follow the guidelines for prevention (USPSTF, 2018). Women ages 40-49 are recommended to have mammography performed every couple of years depending on the patient’s situation. This particular age group (40-49) are categorized as Grade C. Grade C means moderate advantages exist and fully support mammogram screen when the individual has other risk factors to consider (USPSTF, 2018). Women 75 and older are recommended not to have mammogram screen done and are considered Grade I (USPSTF, 2012). Grade I does not have supportive evidence nor any benefits to mammography screenings. The American Cancer Society (2020) recommends women not considered high risk receive mammogram annually between the ages 40 to 54 years of age. Women that are 55 years and older are recommended to skip mammograms every other year (American Cancer Society, 2020). Clinical breast exams and self-performed breast exams are not reliable, therefore, not recommended (American Cancer Society, 2020; USPSTF, 2012). The National Breast Cancer Foundation, INC (2019) recommend women 40 years and above receive a mammogram annually or biennial. Women would do not know their family history should have routine mammograms performed as soon as possible to allow early detection (National Breast Cancer Foundation, INC, 2019). Breast Cancer.org (2020) suggests women age 40 and not at high risk older have annual mammograms along with performing self-breast exams. USPSTF (2018) rate self-breast exams as a Grade D. Grade D is considered to be lacking benefits and harm may result from this category (USPSTF, 2018).  Magnetic Resonance Imaging (MRI) or ultrasound is recommended for highly suspected cases of breast cancer (Breast Cancer.org, 2020). USPSTF (2012) MRI, digital mammography, and clinical breast exams are considered grade I and qualify as inadequate evidence without any benefits to support the need for these tests to be performed (USPSTF, 2012; USPSTF, 2018). For instance, MRI have shown false positives and are more expensive in price (USPSTF, 2012).

 

Lung Cancer Screening (low-dose computed tomography)

 

 Women smokers are more likely to develop lung cancer and therefore, early detection is recommended to diagnose lung cancer and reduce mortality. Low-dose CT scan is the method used to screen lung cancer and the screening is associated with benefits such as reducing mortality and morbidity, increase awareness, and reduce anxiety (Huang et al. 2019).  Organizations that fight cancer state that screening should be done in settings that patients can receive comprehensive care. Patients aged 55-74 who have a history of smoking should discuss with the clinicians (Huang et al. 2019). The purpose of discussion before screening is to share the potential benefits and risks that may occur due to lung cancer screening.  The eligibility criteria include; cigarette smokers aged 55-74, 30 pack-year smoker, and 15 years of quitting (Huang et al. 2019).  However, it is recommended that further eligibility criteria should be added so that a higher population can be screened. For example, other risk factors include age and sex.  The purpose of lung cancer screening is not to diagnose but also to provide patients with chemoprevention strategies.  

Cervical cancer screening

 Tobacco-related mortality among women aged 50-70 years is high. Recent research and studies have found that smoking contributes to 11% cancer cases (Mansour et al. 2019). This indicates that smoking is a risk factor for hrHPV and also smoking has a chemical that hinders the cervical cells from fighting the infection and increases the multiplication of abnormal cervical cells. There is evidence that cancer screening supports smoking cessation and eventually improve health outcomes (Mansour et al. 2019). The relation between cervical screening and smoking cessation is that after the cervical screening, clinicians provide patients with smoking cessation advice. The patients gain knowledge about smoking and motivate them to attend the future screening.

Critique

 Lung cancer and cervical cancer screening are used to detect cancer to improve survival rates.  From the case study, the patients need different cancer screenings since smoking contributes to diseases including lung cancer and cervical cancer (Huang et al. 2019). Thus, both screening play are a similar role of identify illnesses that might have been occurred as a result of smoking. For example, women who are smokers are exposed to tobacco by-products that damages the cervix cells and lead to cervical cancer (Mansour et al. 2019). The chemicals also weaken the immune system and the body is unable to fight the infections. Similarly, smoking has many chemicals that cause lung cancer. Thus, both screening is recommended to find out if smoking has contributed to these illnesses. However, the screening differs in terms of eligibility and therefore it is important to understand the screening practices.  For example, lung cancer screening is recommended for heavy smokers whereas cervical cancer screening is recommended for young women who have started smoking.

 

Conclusion

 Female smokers suffer from different significant risks. Smoking is associated with high cholesterol which then increases the risk of a heart attack.  Smoking affects lung function due to airway obstruction. Tobacco smoking also associated with breast cancer and lung cancer.  On breast cancer, female smokers are exposed to tobacco carcinogens and other chemicals that affect the mammary tissue and induce breast tumors.  All these risk factors cause mortality in smokers and it is recommended to assess several cancer types in accordance with USPSTF.  Note that research and studies show that women are more likely to develop various cancers than men and therefore, screening should be done to find evidence of harm. Female smokers have a risk of developing respiratory issues, cardiovascular issues, and cancer. Female smokers who have a long history will benefit from screening and save their life.

 

 

Reference

Huang, K. L., Wang, S. Y., Lu, W. C., Chang, Y. H., Su, J., & Lu, Y. T. (2019). Effects of low-

dose computed tomography on lung cancer screening: a systematic review, meta-analysis,

and trial sequential analysis. BMC pulmonary medicine, 19(1), 1

 

Mansour, M. B., Crone, M. R., van Weert, H. C., Chavannes, N. H., & van Asselt, K. M. (2019).

Smoking cessation advice after cervical screening: a qualitative interview study of

acceptability in Dutch primary care. Br J Gen Pract, 69(678), e15-e23.