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Page 2 <br />Contract Addendum <br /> <br />1. Personal history of breast cancer; <br />2. Personal history of biopsy-proven benign breast <br /> disease; <br />3. A mother, sister or daughter had breast cancer; or <br />4. Not having given birth prior to age 30. <br /> <br /> If these American Cancer Society (ACS) guidelines are updated, <br />the BCCCP will abide by the new ones. <br /> <br /> Diagnostic mammographies are performed when medically <br />appropriate. <br /> <br /> CERVICAL SCREENING AND FOLLOW UP: For women who are or have <br />been sexually active and are 18 years old or older, the screening <br />includes a bimanual pelvic exam, and a PapanicoIaou smear every <br />year. After a woman has had three or more consecutive satisfactory <br />normal annual examinations, the pap test may be performed less <br />frequently at the discretion of her physician. Repeat pap tests <br />and colposcopy directed biopsies will be provided as medically <br />indicated. <br /> <br />Breast and Cervical Cancer Screenings will be provided to 183 <br />women during the contract period: <br /> <br />170 of these women are 40 years and older and will receive <br /> breast cancer screenings and follow-up. <br />170 of these women are 40 years and older and receive <br /> cervical cancer screenings and follow-up. <br /> 13 of these women are under the age of 40 and receive <br /> cervical cancer screenings and follow-up. <br /> <br /> QUALITY ASSURANCE AND CONTINUOUS QUALITY IMPROVEMENT: The <br />contractor .must. provide ~r assure the provision of high quality <br />services thr0ughout....the program's components. For laboratories, <br />this means Clinical Laboratory Improvement A~endments of 1988 (CLIA <br />'88) certification. The Bethesda System of reporting will be <br />required for results of pap tests. <br /> <br /> For mammography facilities, American College of Radiology <br />(ACR) accreditation must be obtained. Any facility that provides <br />screening services to this program must apply for ACR creditation <br />prior to January 1, 1993. Reporting results will be in accordance <br />with the Categories from the ACR Breast Imaging Reporting and <br />Database System. <br /> <br /> .ACS guidelines must be followed regarding the frequency of <br />screenings. The contractor will assure compliance with these <br />certifications, accreditations and guidelines. <br /> <br /> <br />