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Health Matters: Providence St. Joseph Hospital | 3 "A well woman checkup is vital to a woman's overall health," says Matthew Fore, MD, an OB-GYN on the medical staff at Providence St. Joseph Hospital. "A lot of people have put off this important screening visit during the pandemic, but we have Covid measures in place, and patients should feel comfortable coming in." Dr. Fore, who sees women from adolescence to pregnancy/childbirth to menopause, views the OB-GYN- patient interaction as a gateway to good preventive care. "During the well woman visit, we do a checkup, take blood pressure, and we talk about any concerns she may have regarding her sexual, menstrual or reproductive health. We also talk about when they might want to become pregnant and, of course, contraception. It is also important to gather a family history of cancers—especially breast, ovarian, colon," says Dr. Fore. But, beyond the specifics, Dr. Fore sees this as a time to get to know the patient. "Trust is the most valuable part of any physician-patient relationship, and it needs to be built over time. We can even discuss conditions other than those related to women's health," he says. As for the nuts and bolts of the visit, there are several screenings that are important: Cervical cancer. According to Dr. Fore, there are different recommendations about the time to start and how often to test for cervical cancer with a Pap smear and/or human papillomavirus (HPV) testing (since the presence of HPV can be a precursor to cancer). "I typically follow the newest American Cancer Society (ACS) 2019 guidelines that say that average-risk women can start Pap smears at 25 years old and have them every five years. However, the American College of Obstetricians and Gynecologists (ACOG) recommends that women should start having Pap smears at 21 years old and have them every three years until they are 30. After the age of 30, Pap smears can be every five years." The most critical thing is that we make sure you're not missing out on this important screening, because cervical cancer can often be detected early when it's just a pre-cancer. Also, a pelvic exam does not necessarily mean a Pap smear was collected; so I encourage all my patients to ask exactly what test was done and to call about the results. Mammogram. Again, according to Dr. Fore, this is a discussion with the patient. "While different health care organizations recommend starting between 40 and 50, I typically encourage initiating mammograms at 40 and having them done annually." Bone scan. "In the average-risk patient, I start doing bone scans at 65," says Dr. Fore, "or sooner if there is a history of fracture or other conditions like smoking, alcohol or chronic steroid use." The Importance of Well Woman Visits and Screening Now that Covid precautions are in place, don't hesitate to get preventive screenings. Dr. Matthew Fore

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