CXCAD1
type: StructureDefinition
node role: treeRoot
id:
  v: CXCAD1
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition CXCAD1 Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> <a href="StructureDefinition-CXCAD1-definitions.html#CXCAD1" title="Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.">CXCAD1 <a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( cxca-d1-pregnant-needs-gestational-age, cxca-d1-hiv-positive-needs-art-status, cxca-d1-hysterectomy-needs-indication, cxca-d1-screening-date-not-future )">C 0..* Base CXCA.D1 — Cervical Cancer Screening Anamnesis Constraints: cxca-d1-pregnant-needs-gestational-age, cxca-d1-hiv-positive-needs-art-status, cxca-d1-hysterectomy-needs-indication, cxca-d1-screening-date-not-future #xD; clientAge 1..1 integer Client's age in years on the encounter date #xD; clientEducation 0..1 string Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration) #xD; numberOfPregnancies 0..1 integer Number of pregnancies (gravidity), regardless of outcome #xD; numberOfBirths 0..1 integer Number of live births (parity) #xD; lastMenstrualPeriod 0..1 date First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow. #xD; currentlyPregna…
url:
  v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
  l: CXCAD1
version:
  v: 0.0.1
name:
  v: CXCAD1
title:
  v: CXCA.D1 — Cervical Cancer Screening Anamnesis
status:
  v: draft
experimental:
  v: false
date:
  v: 2026-05-14T00:50:23+00:00
publisher:
  v: Dan Heslinga (independent contributor)
contact:
  name:
    v: Dan Heslinga (independent contributor)
  telecom:
    system:
      v: url
    value:
      v: https://github.com/dhes
description:
  v: Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.
fhir version:
  v: 4.0.1
kind:
  v: logical
abstract:
  v: false
type:
  v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
  l: CXCAD1
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Base
  l: Base
derivation:
  v: specialization
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: CXCAD1
    path:
      v: CXCAD1
    short:
      v: CXCA.D1 — Cervical Cancer Screening Anamnesis
    definition:
      v: Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Base
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: cxca-d1-pregnant-needs-gestational-age
      severity:
        v: error
      human:
        v: If currentlyPregnant = true, gestationalAgeWeeks must be provided
      expression:
        v: currentlyPregnant.empty() or currentlyPregnant = false or gestationalAgeWeeks.exists()
      source:
        v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
        l: CXCAD1
    constraint:
      key:
        v: cxca-d1-hiv-positive-needs-art-status
      severity:
        v: error
      human:
        v: If hivStatus indicates HIV-positive (CXCA.D#DE17), currentlyOnART must be provided
      expression:
        v: hivStatus.empty() or hivStatus.code != 'DE17' or currentlyOnART.exists()
      source:
        v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
        l: CXCAD1
    constraint:
      key:
        v: cxca-d1-hysterectomy-needs-indication
      severity:
        v: error
      human:
        v: If hadHysterectomy = true, hysterectomyForCervicalCancer must be provided
      expression:
        v: hadHysterectomy.empty() or hadHysterectomy = false or hysterectomyForCervicalCancer.exists()
      source:
        v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
        l: CXCAD1
    constraint:
      key:
        v: cxca-d1-screening-date-not-future
      severity:
        v: error
      human:
        v: Last screening date cannot be in the future
      expression:
        v: lastScreeningDate.empty() or lastScreeningDate <= today()
      source:
        v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
        l: CXCAD1
    is modifier:
      v: false
  element:
    id:
      v: CXCAD1.clientAge
    path:
      v: CXCAD1.clientAge
    short:
      v: Client's age in years on the encounter date
    definition:
      v: Client's age in years on the encounter date
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: CXCAD1.clientAge
      min:
        v: 1
      max:
        v: 1
    type:
      code:
        v: integer
        l: integer
  element:
    id:
      v: CXCAD1.clientEducation
    path:
      v: CXCAD1.clientEducation
    short:
      v: Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)
    definition:
      v: Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: CXCAD1.clientEducation
      min:
        v: 0
      max:
        v: 1
    type:
      code:
        v: string
        l: string
  element:
    id:
      v: CXCAD1.numberOfPregnancies
    path:
      v: CXCAD1.numberOfPregnancies
    short:
      v: Number of pregnancies (gravidity), regardless of outcome
    definition:
      v: Number of pregnancies (gravidity), regardless of outcome
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: CXCAD1.numberOfPregnancies
      min:
        v: 0
      max:
        v: 1
    type:
      code:
        v: integer
        l: integer
  element:
    id:
      v: CXCAD1.numberOfBirths

v: CXCAD1.numberOfBirths

v: Number of live births (parity)

v: Number of live births (parity)

v: 0

v: 1

path:
  v: CXCAD1.numberOfBirths
min:
  v: 0
max:
  v: 1

code:
  v: integer
  l: integer

id:
  v: CXCAD1.lastMenstrualPeriod
path:
  v: CXCAD1.lastMenstrualPeriod
short:
  v: First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.
definition:
  v: First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.lastMenstrualPeriod
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date

id:
  v: CXCAD1.currentlyPregnant
path:
  v: CXCAD1.currentlyPregnant
short:
  v: Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.
definition:
  v: Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.currentlyPregnant
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.gestationalAgeWeeks
path:
  v: CXCAD1.gestationalAgeWeeks
short:
  v: If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.
definition:
  v: If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.gestationalAgeWeeks
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.currentContraception
path:
  v: CXCAD1.currentContraception
short:
  v: Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)
definition:
  v: Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.currentContraception
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string

id:
  v: CXCAD1.pastContraception
path:
  v: CXCAD1.pastContraception
short:
  v: Description of past contraception methods used (free text)
definition:
  v: Description of past contraception methods used (free text)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.pastContraception
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string

id:
  v: CXCAD1.ageAtFirstSexualContact
path:
  v: CXCAD1.ageAtFirstSexualContact
short:
  v: Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.
definition:
  v: Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.ageAtFirstSexualContact
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.ageAtFirstDelivery
path:
  v: CXCAD1.ageAtFirstDelivery
short:
  v: Client's age in years at first delivery (if any). Risk factor.
definition:
  v: Client's age in years at first delivery (if any). Risk factor.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.ageAtFirstDelivery
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.numberOfSexualPartners
path:
  v: CXCAD1.numberOfSexualPartners
short:
  v: Lifetime number of sexual partners. Risk factor.
definition:
  v: Lifetime number of sexual partners. Risk factor.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.numberOfSexualPartners
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.hasHadSTI
path:
  v: CXCAD1.hasHadSTI
short:
  v: Whether the client has had any sexually transmitted infection. Risk factor.
definition:
  v: Whether the client has had any sexually transmitted infection. Risk factor.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hasHadSTI
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hivStatus
path:
  v: CXCAD1.hivStatus
short:
  v: Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.
definition:
  v: Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hivStatus
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.currentlyOnART
path:
  v: CXCAD1.currentlyOnART
short:
  v: If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.
definition:
  v: If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.currentlyOnART
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.lastScreeningDate
path:
  v: CXCAD1.lastScreeningDate
short:
  v: Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.
definition:
  v: Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.lastScreeningDate
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date

id:
  v: CXCAD1.lastScreeningType
path:
  v: CXCAD1.lastScreeningType
short:
  v: Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).
definition:
  v: Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.lastScreeningType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.lastScreeningResult
path:
  v: CXCAD1.lastScreeningResult
short:
  v: Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).
definition:
  v: Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.lastScreeningResult
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.hadHysterectomy
path:
  v: CXCAD1.hadHysterectomy
short:
  v: Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.
definition:
  v: Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hadHysterectomy
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hysterectomyForCervicalCancer
path:
  v: CXCAD1.hysterectomyForCervicalCancer
short:
  v: If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.
definition:
  v: If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hysterectomyForCervicalCancer
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.smokingStatus
path:
  v: CXCAD1.smokingStatus
short:
  v: Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).
definition:
  v: Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.smokingStatus
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.alcoholUse
path:
  v: CXCAD1.alcoholUse
short:
  v: Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.
definition:
  v: Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.alcoholUse
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hasPostcoitalBleeding
path:
  v: CXCAD1.hasPostcoitalBleeding
short:
  v: Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.
definition:
  v: Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hasPostcoitalBleeding
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hasIntermenstrualBleeding
path:
  v: CXCAD1.hasIntermenstrualBleeding
short:
  v: Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.
definition:
  v: Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hasIntermenstrualBleeding
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hasUnusualDischarge
path:
  v: CXCAD1.hasUnusualDischarge
short:
  v: Whether the client reports unusual vaginal discharge.
definition:
  v: Whether the client reports unusual vaginal discharge.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CXCAD1.hasUnusualDischarge
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean

element:
  id:
    v: CXCAD1
  path:
    v: CXCAD1
  short:
    v: CXCA.D1 — Cervical Cancer Screening Anamnesis
  definition:
    v: Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.
  constraint:
    key:
      v: cxca-d1-pregnant-needs-gestational-age
    severity:
      v: error
    human:
      v: If currentlyPregnant = true, gestationalAgeWeeks must be provided
    expression:
      v: currentlyPregnant.empty() or currentlyPregnant = false or gestationalAgeWeeks.exists()
    source:
      v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
      l: CXCAD1
  constraint:
    key:
      v: cxca-d1-hiv-positive-needs-art-status
    severity:
      v: error
    human:
      v: If hivStatus indicates HIV-positive (CXCA.D#DE17), currentlyOnART must be provided
    expression:
      v: hivStatus.empty() or hivStatus.code != 'DE17' or currentlyOnART.exists()
    source:
      v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
      l: CXCAD1
  constraint:
    key:
      v: cxca-d1-hysterectomy-needs-indication
    severity:
      v: error
    human:
      v: If hadHysterectomy = true, hysterectomyForCervicalCancer must be provided
    expression:
      v: hadHysterectomy.empty() or hadHysterectomy = false or hysterectomyForCervicalCancer.exists()
    source:
      v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
      l: CXCAD1
  constraint:
    key:
      v: cxca-d1-screening-date-not-future
    severity:
      v: error
    human:
      v: Last screening date cannot be in the future
    expression:
      v: lastScreeningDate.empty() or lastScreeningDate <= today()
    source:
      v: http://smart.who.int/cxca/StructureDefinition/CXCAD1
      l: CXCAD1
element:
  id:
    v: CXCAD1.clientAge
  path:
    v: CXCAD1.clientAge
  short:
    v: Client's age in years on the encounter date
  definition:
    v: Client's age in years on the encounter date
  min:
    v: 1
  max:
    v: 1
  type:
    code:
      v: integer
      l: integer
element:
  id:
    v: CXCAD1.clientEducation
  path:
    v: CXCAD1.clientEducation
  short:
    v: Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)
  definition:
    v: Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: string
      l: string
element:
  id:
    v: CXCAD1.numberOfPregnancies
  path:
    v: CXCAD1.numberOfPregnancies
  short:
    v: Number of pregnancies (gravidity), regardless of outcome
  definition:
    v: Number of pregnancies (gravidity), regardless of outcome
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: integer
      l: integer
element:
  id:
    v: CXCAD1.numberOfBirths
  path:
    v: CXCAD1.numberOfBirths
  short:
    v: Number of live births (parity)
  definition:
    v: Number of live births (parity)
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: integer
      l: integer
element:
  id:
    v: CXCAD1.lastMenstrualPeriod
  path:
    v: CXCAD1.lastMenstrualPeriod
  short:
    v: First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.
  definition:
    v: First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: date
      l: date
element:
  id:
    v: CXCAD1.currentlyPregnant
  path:
    v: CXCAD1.currentlyPregnant
  short:
    v: Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.
  definition:
    v: Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: boolean
      l: boolean
element:
  id:
    v: CXCAD1.gestationalAgeWeeks
  path:
    v: CXCAD1.gestationalAgeWeeks
  short:
    v: If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.
  definition:
    v: If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: integer
      l: integer
element:
  id:
    v: CXCAD1.currentContraception
  path:
    v: CXCAD1.currentContraception
  short:
    v: Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)
  definition:
    v: Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: string
      l: string
element:
  id:
    v: CXCAD1.pastContraception
  path:
    v: CXCAD1.pastContraception
  short:
    v: Description of past contraception methods used (free text)
  definition:
    v: Description of past contraception methods used (free text)

v: 0

v: 1

code:
  v: string
  l: string

id:
  v: CXCAD1.ageAtFirstSexualContact
path:
  v: CXCAD1.ageAtFirstSexualContact
short:
  v: Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.
definition:
  v: Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.ageAtFirstDelivery
path:
  v: CXCAD1.ageAtFirstDelivery
short:
  v: Client's age in years at first delivery (if any). Risk factor.
definition:
  v: Client's age in years at first delivery (if any). Risk factor.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.numberOfSexualPartners
path:
  v: CXCAD1.numberOfSexualPartners
short:
  v: Lifetime number of sexual partners. Risk factor.
definition:
  v: Lifetime number of sexual partners. Risk factor.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: CXCAD1.hasHadSTI
path:
  v: CXCAD1.hasHadSTI
short:
  v: Whether the client has had any sexually transmitted infection. Risk factor.
definition:
  v: Whether the client has had any sexually transmitted infection. Risk factor.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hivStatus
path:
  v: CXCAD1.hivStatus
short:
  v: Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.
definition:
  v: Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.currentlyOnART
path:
  v: CXCAD1.currentlyOnART
short:
  v: If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.
definition:
  v: If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.lastScreeningDate
path:
  v: CXCAD1.lastScreeningDate
short:
  v: Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.
definition:
  v: Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: date
    l: date

id:
  v: CXCAD1.lastScreeningType
path:
  v: CXCAD1.lastScreeningType
short:
  v: Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).
definition:
  v: Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.lastScreeningResult
path:
  v: CXCAD1.lastScreeningResult
short:
  v: Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).
definition:
  v: Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.hadHysterectomy
path:
  v: CXCAD1.hadHysterectomy
short:
  v: Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.
definition:
  v: Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hysterectomyForCervicalCancer
path:
  v: CXCAD1.hysterectomyForCervicalCancer
short:
  v: If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.
definition:
  v: If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.smokingStatus
path:
  v: CXCAD1.smokingStatus
short:
  v: Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).
definition:
  v: Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Coding
    l: Coding

id:
  v: CXCAD1.alcoholUse
path:
  v: CXCAD1.alcoholUse
short:
  v: Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.
definition:
  v: Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hasPostcoitalBleeding
path:
  v: CXCAD1.hasPostcoitalBleeding
short:
  v: Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.
definition:
  v: Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hasIntermenstrualBleeding
path:
  v: CXCAD1.hasIntermenstrualBleeding
short:
  v: Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.
definition:
  v: Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean

id:
  v: CXCAD1.hasUnusualDischarge
path:
  v: CXCAD1.hasUnusualDischarge
short:
  v: Whether the client reports unusual vaginal discharge.
definition:
  v: Whether the client reports unusual vaginal discharge.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: boolean
    l: boolean