@prefix fhir: . @prefix owl: . @prefix rdf: . @prefix rdfs: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:PlanDefinition ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "CXCAD2DTScreeningEligibility"] ; # fhir:meta [ fhir:profile ( [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"^^xsd:anyURI ; fhir:l ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div [ fhir:v "
\n
\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n\n \n \n \n \n \n \n\n \n\n \n \n \n \n \n \n\n \n\n \n \n \n \n \n \n\n \n\n \n \n \n \n \n \n\n \n\n \n \n \n \n \n \n\n \n \n \n \n \n \n\n \n \n \n \n \n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n \n \n \n \n \n\n \n \n \n \n \n \n
Id: CXCAD2DTScreeningEligibility
Url: CXCA.D2.DT — Cervical Cancer Screening Eligibility
Version: 0.0.1
Title: CXCA.D2.DT — Cervical Cancer Screening Eligibility
Status: draft
Type: \n \n \n \n

\n system: http://terminology.hl7.org/CodeSystem/plan-definition-type\n

\n \n \n

\n code: eca-rule\n

\n \n \n \n \n \n
Date: 2026-05-14 00:50:23+0000
Publisher: Dan Heslinga (independent contributor)
Description:

Decision support recommendation for cervical cancer screening eligibility (CXCA.D2). Evaluates the rules from Mongolia MOH Order A/641 (2020) section 2.2 via the CXCAD2DTScreeningEligibilityLogic CQL library; when the client is due, recommends instantiating the CXCAD2HPVScreeningServiceRequest ActivityDefinition.

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Libraries: \n \n \n \n \n \n \n
CXCAD2DTScreeningEligibilityLogic
\n
Actions: \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
\n \n Recommend HPV high-risk DNA screening (client is due): Client is at the binding target age (35 or 45 per A/641 section 2.2), has not had a hysterectomy, and has not been screened in the current cycle. Create a proposed ServiceRequest for HPV high-risk DNA testing.\n \n
\n \n \n If:\n \n Applicability:\n \n (Client is due for HPV screening (legal binding))\n
\n \n \n \n \n Then: Definition: CXCAD2 — HPV Screening Service Request
\n \n \n \n
\n \n Defer screening — client already screened in current cycle: Client is at a binding target age but has had a recent valid HPV screening result. Per A/641 section 2.2 they are not due for re-screening at this encounter. Inform the client of their next due date.\n \n
\n \n \n If:\n \n Applicability:\n \n (Client not due — already screened in current cycle (legal binding))\n
\n \n \n \n \n \n
\n \n Defer screening — client outside binding target age range: Client is not at a binding target age (35 or 45 per A/641 section 2.2 for HPV-test-capable facilities). Note: cytology-only facilities follow a different age cycle (30, 33, 36, ..., 60 every 3 years per A/641 section 2.2 cytology pathway) — see the separate cytology-pathway PlanDefinition (deferred to a future Phase 5 chunk).\n \n
\n \n \n If:\n \n Applicability:\n \n (Client excluded — outside target age range (legal binding))\n
\n \n \n \n \n \n
\n \n Exclude from screening — prior hysterectomy: Client has had a hysterectomy. Per A/641 section 2.2, women who have had a hysterectomy for non-cervical-cancer indication and who have a documented negative post-operative vaginal-smear cytology are exempt from cervical cancer screening. Verify the indication and the post-operative cytology status before fully excluding.\n \n
\n \n \n If:\n \n Applicability:\n \n (Client excluded — prior hysterectomy (legal binding))\n
\n \n \n \n \n \n
\n
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"^^rdf:XMLLiteral ] ] ; # fhir:contained ( [ a fhir:Library ; fhir:id [ fhir:v "effective-data-requirements" ] ; fhir:extension ( [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTScreeningEligibilityLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Client age" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "// =============================================================================\n// Helper definitions\n// =============================================================================\n\n/*\n * Client age in years at the encounter date.\n */\ndefine \"Client age\":\n AgeInYearsAt(Today)" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 0 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTScreeningEligibilityLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Client is at binding target age (35 or 45)" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * The client is at one of the binding target ages per A/641 section 2.2\n * (HPV-test-capable facilities: ages 35 and 45 only).\n */\ndefine \"Client is at binding target age (35 or 45)\":\n \"Client age\" = 35 or \"Client age\" = 45" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 1 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAElements" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Hysterectomy Procedures" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "// =============================================================================\n// Hysterectomy history\n// =============================================================================\n\n/*\n * @internal: All recorded hysterectomy procedures for this patient,\n * filtered to status = completed.\n */\ndefine \"Hysterectomy Procedures\":\n [Procedure] P\n where P.status = 'completed'\n and exists (P.code.coding C where C.code = 'DE45'\n and C.system = 'http://smart.who.int/cxca/CodeSystem/CXCA.D')" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 2 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAElements" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Has Had Hysterectomy" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * The patient has a documented completed hysterectomy.\n *\n * NOTE: A/641 section 2.2 only excludes hysterectomy for non-cervical-cancer indication\n * with a documented negative post-op vaginal-smear cytology. This define\n * captures only the hysterectomy fact; the indication and post-op cytology\n * checks live in higher-layer logic that combines this define with others.\n */\ndefine \"Has Had Hysterectomy\":\n exists \"Hysterectomy Procedures\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 3 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTScreeningEligibilityLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Client is due for HPV screening (legal binding)" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "// =============================================================================\n// Legal-binding eligibility tree — A/641 section 2.2 (HPV at ages 35 and 45)\n// Bindingness: legal\n// =============================================================================\n\n/*\n * @output: CXCA.D#DE4 \"Due for HPV screening\"\n * @bindingness: legal\n * Client is due if at a binding target age, has not had a hysterectomy,\n * and has not been screened in the current cycle.\n */\ndefine \"Client is due for HPV screening (legal binding)\":\n \"Client is at binding target age (35 or 45)\"\n and not Elements.\"Has Had Hysterectomy\"\n and not \"HasRecentHPVScreening\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 4 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTScreeningEligibilityLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Client excluded — prior hysterectomy (legal binding)" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * @output: CXCA.D#DE7 \"Excluded — prior hysterectomy\"\n * @bindingness: legal\n * Client has had a hysterectomy for non-cervical-cancer indication and is\n * therefore exempt from cervical cancer screening per A/641 section 2.2.\n */\ndefine \"Client excluded — prior hysterectomy (legal binding)\":\n Elements.\"Has Had Hysterectomy\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 5 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTScreeningEligibilityLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Client excluded — outside target age range (legal binding)" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * @output: CXCA.D#DE6 \"Excluded — outside target age range\"\n * @bindingness: legal\n * Client is not at a binding target age (35 or 45 only for HPV-capable facilities).\n */\ndefine \"Client excluded — outside target age range (legal binding)\":\n not \"Client is at binding target age (35 or 45)\"\n and not Elements.\"Has Had Hysterectomy\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 6 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTScreeningEligibilityLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Client not due — already screened in current cycle (legal binding)" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * @output: CXCA.D#DE5 \"Not due — already screened in current cycle\"\n * @bindingness: legal\n * Client is at a target age but has had a recent valid HPV screening result.\n */\ndefine \"Client not due — already screened in current cycle (legal binding)\":\n \"Client is at binding target age (35 or 45)\"\n and \"HasRecentHPVScreening\"\n and not Elements.\"Has Had Hysterectomy\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 7 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "FHIRHelpers" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "ToString" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "define function ToString(value ProcedureStatus): value.value" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 8 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "FHIRHelpers" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "ToString" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "define function ToString(value string): value.value" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 9 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "FHIRHelpers" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "ToString" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "define function ToString(value uri): value.value" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 10 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] ) ; fhir:name [ fhir:v "EffectiveDataRequirements" ] ; fhir:status [ fhir:v "active" ] ; fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "module-definition" ] ] ) ] ; fhir:relatedArtifact ( [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "FHIR model information" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1"^^xsd:anyURI ; fhir:l ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Library Elements" ] ; fhir:resource [ fhir:v "http://smart.who.int/cxca/Library/CXCAElements"^^xsd:anyURI ; fhir:l ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Library FHIRHelpers" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"^^xsd:anyURI ; fhir:l ] ] ) ; fhir:parameter ( [ fhir:name [ fhir:v "Today" ] ; fhir:use [ fhir:v "in" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "date" ] ] [ fhir:name [ fhir:v "HasRecentHPVScreening" ] ; fhir:use [ fhir:v "in" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Client is due for HPV screening (legal binding)" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Client excluded — prior hysterectomy (legal binding)" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Client excluded — outside target age range (legal binding)" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Client not due — already screened in current cycle (legal binding)" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] ) ; fhir:dataRequirement ( [ fhir:type [ fhir:v "Patient" ] ; fhir:profile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Patient"^^xsd:anyURI ; fhir:l ] ) ] [ fhir:type [ fhir:v "Procedure" ] ; fhir:profile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Procedure"^^xsd:anyURI ; fhir:l ] ) ; fhir:mustSupport ( [ fhir:v "status" ] [ fhir:v "code" ] [ fhir:v "code.coding" ] ) ] [ fhir:type [ fhir:v "Procedure" ] ; fhir:profile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Procedure"^^xsd:anyURI ; fhir:l ] ) ; fhir:mustSupport ( [ fhir:v "status" ] [ fhir:v "code" ] [ fhir:v "code.coding" ] ) ] [ fhir:type [ fhir:v "Procedure" ] ; fhir:profile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Procedure"^^xsd:anyURI ; fhir:l ] ) ; fhir:mustSupport ( [ fhir:v "status" ] [ fhir:v "code" ] [ fhir:v "code.coding" ] ) ] ) ] ) ; # fhir:extension ( [ fhir:url [ fhir:v "http://smart.who.int/cxca/StructureDefinition/cxca-bindingness"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://smart.who.int/cxca/CodeSystem/CXCA.Bindingness"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "legal" ] ; fhir:display [ fhir:v "Legal — binding regulatory instrument" ] ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Canonical ; fhir:v "#effective-data-requirements"^^xsd:anyURI ; fhir:l <#effective-data-requirements> ] ] ) ; # fhir:url [ fhir:v "http://smart.who.int/cxca/PlanDefinition/CXCAD2DTScreeningEligibility"^^xsd:anyURI ; fhir:l ] ; # fhir:version [ fhir:v "0.0.1"] ; # fhir:name [ fhir:v "CXCAD2DTScreeningEligibility"] ; # fhir:title [ fhir:v "CXCA.D2.DT — Cervical Cancer Screening Eligibility"] ; # fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/plan-definition-type"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "eca-rule" ] ] ) ] ; # fhir:status [ fhir:v "draft"] ; # fhir:experimental [ fhir:v false] ; # fhir:date [ fhir:v "2026-05-14T00:50:23+00:00"^^xsd:dateTime] ; # fhir:publisher [ fhir:v "Dan Heslinga (independent contributor)"] ; # fhir:contact ( [ fhir:name [ fhir:v "Dan Heslinga (independent contributor)" ] ; fhir:telecom ( [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://github.com/dhes" ] ] ) ] ) ; # fhir:description [ fhir:v "Decision support recommendation for cervical cancer screening eligibility (CXCA.D2). Evaluates the rules from Mongolia MOH Order A/641 (2020) section 2.2 via the CXCAD2DTScreeningEligibilityLogic CQL library; when the client is due, recommends instantiating the CXCAD2HPVScreeningServiceRequest ActivityDefinition."] ; # fhir:library ( [ fhir:v "http://smart.who.int/cxca/Library/CXCAD2DTScreeningEligibilityLogic"^^xsd:anyURI ; fhir:l ] ) ; # fhir:action ( [ fhir:title [ fhir:v "Recommend HPV high-risk DNA screening (client is due)" ] ; fhir:description [ fhir:v "Client is at the binding target age (35 or 45 per A/641 section 2.2), has not had a hysterectomy, and has not been screened in the current cycle. Create a proposed ServiceRequest for HPV high-risk DNA testing." ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Client is due for HPV screening (legal binding)" ] ] ] ) ; fhir:definition [ a fhir:Canonical ; fhir:v "http://smart.who.int/cxca/ActivityDefinition/CXCAD2HPVScreeningServiceRequest"^^xsd:anyURI ; fhir:l ] ] [ fhir:title [ fhir:v "Defer screening — client already screened in current cycle" ] ; fhir:description [ fhir:v "Client is at a binding target age but has had a recent valid HPV screening result. Per A/641 section 2.2 they are not due for re-screening at this encounter. Inform the client of their next due date." ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Client not due — already screened in current cycle (legal binding)" ] ] ] ) ] [ fhir:title [ fhir:v "Defer screening — client outside binding target age range" ] ; fhir:description [ fhir:v "Client is not at a binding target age (35 or 45 per A/641 section 2.2 for HPV-test-capable facilities). Note: cytology-only facilities follow a different age cycle (30, 33, 36, ..., 60 every 3 years per A/641 section 2.2 cytology pathway) — see the separate cytology-pathway PlanDefinition (deferred to a future Phase 5 chunk)." ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Client excluded — outside target age range (legal binding)" ] ] ] ) ] [ fhir:title [ fhir:v "Exclude from screening — prior hysterectomy" ] ; fhir:description [ fhir:v "Client has had a hysterectomy. Per A/641 section 2.2, women who have had a hysterectomy for non-cervical-cancer indication and who have a documented negative post-operative vaginal-smear cytology are exempt from cervical cancer screening. Verify the indication and the post-operative cytology status before fully excluding." ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Client excluded — prior hysterectomy (legal binding)" ] ] ] ) ] ) . # # -------------------------------------------------------------------------------------