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July 2018
Timely information from Ladies First!  
Test Your Knowledge: Case Review
Anogenital and HPV-related diseases
Each month, ASCCP releases a new case review that will allow you to test your knowledge in anogenital and HPV-related diseases. Click here>   
Pride Center of VT  

Addressing barriers to
health care
The Pride Center of Vermont is working with the Ladies First program on two main goals: to offer Ladies First services to all eligible people in Vermont and to educate providers and people in the LGBTQ community about Pap and mammogram screening needs. To kick off the work, the Pride Center is conducting:    
  • Training for providers to encourage medical practices to welcome members of the LGBTQ community and provide information that is appropriate to educate and encourage breast and cervical cancer screenings. 
  • Materials for distribution to help facilitate this outreach with the slogan Got 'em? Screen 'em! keeping in mind that some people that don't necessarily identify as female have breasts and a cervix.
If you are interested in finding out more about the collaboration between Pride Center and Ladies First or how you can get involved - let us know! Call us at (800) 508-2222.
VT Mammography Facilities

Review of universal design and accessibility 
The Chronic Disease and Disability Program, Ladies First and community partners are working together to identify and promote mammography facilities that make breast imaging accessible to all women.  
Among women in Vermont ages 50-74, 81% of women without a disability report receiving recommended breast imaging while only 72% of women with disabilities report receiving the same recommended breast imaging (BRFSS, 2016). The goal of the effort is to explore the barriers that women with disabilities face when accessing Vermont mammography facilities.
While visiting Vermont mammography facilities partners walk through routes of
travel, available public services and amenities, and breast imaging services and accommodations. Also, the partners are assessing mammography technologist
interest in further professional development. Topics of interest so far include cultural competency, strategies to provide care for women with mobility disabilities and/or developmental disabilities and more. Of the 16 mammography facilities located throughout Vermont, 4 facilities have been visited to date.  
If you would like your mammography facility assessed, please contact Allie Perline at (802) 951-0157. 
Unsatisfactory Pap ?
How to manage

A Pap smear reported as "Unsatisfactory" is a frustrating outcome for both the provider and the Ladies First member. It can lead to increased anxiety, embarrassment and inconvenience as the smear needs to be repeated. Below are ASCCP management guidelines:
1. Repeat cytology 2-4 months later is recommended for women with unsatisfactory cytology. hrHPV triage testing is not recommended. Women with unsatisfactory cytology may receive
treatment to resolve atrophy or obscuring inflammation (when a specific infection is noted) prior to this repeat cytology. If a Pap test is unsatisfactory due to low cellularity in a woman with a recent negative screening history (i.e., the current, unsatisfactory Pap was taken at a shorter interval than suggested in the screening guidelines), the time of the repeat Pap test triggered by the current unsatisfactory Pap test can be adjusted to a longer time interval.  
2. Colposcopy is recommended when a woman has had two consecutive unsatisfactory
cytology tests.