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LABORATORY SCREENINGS PROVIDED THROUGH CWP

CHOLESTEROL SCREENING
Cholesterol is a laboratory test used to estimate risk of developing a disease - specifically heart disease. Because high blood cholesterol has been associated with hardening of the arteries (atherosclerosis), heart disease, and a raised risk of death from heart attacks; cholesterol testing is considered a routine part of preventive health care. Participants must fast for 10-12 hours prior to this screening, only water is permitted.

GLUCOSE SCREENING
Also known as blood sugar or fasting blood sugar, the blood glucose test is ordered to measure the amount of glucose in the blood right at the time of the sample collection. It is used to detect both hyperglycemia and hypoglycemia, to help diagnose diabetes, and to monitor glucose levels in persons with diabetes. Blood glucose testing can be used to screen healthy, symptomatic individuals for diabetes and pre-diabetes since diabetes is a common disease that begins with only a few symptoms. Screening is especially important for people at high risk of developing diabetes, such as those with a family history of diabetes, those who are overweight, and those who are more than 40 to 45 years old. Participants must fast for 10-12 hours prior to this screening, only water is permitted.

BLOOD LIPID PANEL
Also known as a lipid panel, the blood lipid panel is a group of tests that are often ordered together to determine risk of coronary heart disease, and to help guide you and your health care provider in deciding what treatment may be best for you if you have borderline or high risk. This laboratory test has been shown to be a good indicator of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels or hardening of the arteries (atherosclerosis). The lipid panel includes: Total cholesterol, High density lipoprotein cholesterol (HDL-C) - often called good cholesterol, Low density lipoprotein cholesterol (LDL-C) -often called bad cholesterol , Triglycerides and Cholesterol/HDL ratio. Talk to your doctor about what these other reported values may mean for you. The results of the lipid profile are considered along with other known risk factors of heart disease to develop a plan of treatment and follow-up. You may be screened using only a cholesterol test and not a full lipid panel. However, if the cholesterol test result is high, you may have follow-up testing with a lipid panel. If you have other risk factors or have had a high cholesterol level in the past, you should be tested more regularly and you should have a full lipid panel.
Risk factors include:

• Cigarette smoking
• Age (if you are a male 45 years or older or a female 55 years or older)
• Low HDL cholesterol (less than 40 mg/dL)
• Hypertension (Blood Pressure of 140/90 or higher or taking high blood pressure medications)
• Family history of premature heart disease (heart disease in a first degree male relative under age 55 or a first degree female relative under age 65)
• Diabetes

Note: High HDL (60 mg/dL or above) is considered a "negative risk factor" (also considered the 'good' cholesterol) and its presence allows the removal of one risk factor from the total panel of tests. Participants must fast for 10-12 hours prior to this screening, only water is permitted.

A1c
The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also often called glycosylated) hemoglobin A1c. The A1c test may be used to screen for and diagnose diabetes. The A1c is used to monitor a person's diabetes and to aid in treatment decisions; to screen for and/or diagnose diabetes and pre-diabetes. The goal of individuals with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. It can assist you and your doctor on the measures you are taking to control your diabetes successfully or if adjustments need to be made. Participants must fast for 10-12 hours prior to this screening, only water is permitted.

COMPREHENSIVE METABOLIC PANEL (CMP)
The CMP is used as a broad screening tool to evaluate organ function and check for conditions such as diabetes, liver disease and kidney disease. The CMP may also be ordered to monitor known conditions, such as hypertension, and to monitor patients taking specific medications for any kidney- or liver-related side effects. The CMP gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed. The CMP includes: Glucose and Calcium (both increased and decreased levels can be significant), the proteins Albumin and Total Protein (both increases and decreases in these test results can be significant), the electrolytes Sodium, Potassium, CO2 and Chloride (electrolyte and acid-base imbalances can be present with a wide variety of acute and chronic illnesses, the kidney tests BUN and Creatinine (increased concentrations in the blood may indicate a temporary or chronic decrease in kidney function). When not ordered as part of the CMP, they are still usually ordered together, the liver tests ALP, ALT, AST and Bilirubin (all can be found in elevated concentrations in the blood with liver disease or dysfunction). Participants must fast for 10-12 hours prior to this screening, only water is permitted.

COMPLETE BLOOD COUNT (CBC)
The CBC is used to determine general health status and to screen for and monitor a variety of disorders, such as anemia. Many patients will have baseline CBC tests to help determine their general health status. If they are healthy and they have cell populations that are within normal limits, then they may not require another CBC until their health status changes or until their doctor feels that it is necessary. If a patient is having symptoms such as fatigue or weakness or has an infection, inflammation, bruising, or bleeding, then the doctor may order a CBC to help diagnose the cause. Significant increases in WBCs may help confirm that an infection is present and suggest the need for further testing to identify its cause. Decreases in the number of RBCs (anemia) can be further evaluated by changes in size or shape of the RBCs to help determine if the cause might be decreased production, increased loss, or increased destruction of RBCs. A platelet count that is low or extremely high may confirm the cause of excessive bleeding or clotting and can also be associated with diseases of the bone marrow such as leukemia. No fasting is required for this laboratory screening.

THYROID
A thyroid panel is a group of tests to help evaluate thyroid gland function and to help diagnose thyroid disorders. The tests included in a thyroid panel measure the amount of thyroid hormones in your blood. These hormones are clinical substances that travel through the bloodstream and control or regulate your body's metabolism-how it functions and uses energy. TSH is produced by the pituitary gland and is part of the body's feedback system to maintain stable amounts of the thyroid hormones T4 and T3 in the blood. When concentrations decrease in the blood, the pituitary is stimulated to release TSH. The TSH in turn stimulates the production and release of T4 and T3 by the thyroid gland. When the system is functioning normally, thyroid production turns on and off to maintain constant blood thyroid hormone levels. A thyroid panel is used to screen for or help diagnose hypo- and hyperthyroidism due to various thyroid disorders. A thyroid panel may be ordered as part of a health checkup or when symptoms suggest hypo- or hyperthyroidism due to a condition affecting the thyroid. Signs and symptoms of hypothyroidism may include weight gain, dry skin, constipation, cold intolerance, puffy skin, hair loss, fatigue, and menstrual irregularity in women. Signs and symptoms of hyperthyroidism may include increased heart rate, anxiety, weight loss, difficulty sleeping, tremors in the hands, weakness, and sometimes diarrhea. There may be puffiness around the eyes, dryness, irritation, and, in some cases, bulging of the eyes. No fasting is required for this laboratory screening.

PSA (Prostate Specific Antigen)
The PSA screening is used to screen asymptomatic and symptomatic men for prostate cancer, to help determine the necessity for a biopsy of the prostate, to monitor the effectiveness of treatment for prostate cancer, and to detect recurrence of prostate cancer. The PSA may be ordered during and at regular intervals after prostate cancer treatment, or when a man has symptoms suggestive of prostate cancer such as difficult, painful, and/or frequent urination. The frequency of prostate cancer screening is an individual decision that should be determined through discussion with your physician. There is currently no consensus among the experts about when the PSA test should be ordered to screen asymptomatic males. Over-diagnosing, identifying cases of prostate cancer that may never cause significant health problems must be balanced against missing the detection of aggressive cancers. American Cancer Society (ACS), recommend that doctors offer total PSA tests and DRE annually to all men, beginning at age 50 and to those at an increased risk of prostate cancer, such as American men of African descent and men with a family history of the disease, beginning at age 40 or 45. The ACS recommends that doctors discuss the testing options, benefits, and potential side effects with their male patients so that they can make informed choices. The normal value for total PSA is considered to be less than 4.0 ng/ml (nanograms per milliliter of blood). There are some that feel that this level should be lowered to 2.5 ng/ml in order to detect more cases of prostate cancer. Others argue that this would exacerbate over-diagnosing and over-treating cancers that are not clinically significant. Men with a total PSA level greater than 10.0 ng/ml are at an increased risk for prostate cancer (more than a 67% chance, according to the ACS). Levels between 4.0 ng/ml and 10.0 ng/ml may indicate prostate cancer (about a 25% chance, according to the ACS), BPH, or prostatitis. These conditions are more common in the elderly, as is a general increase in PSA levels. Concentrations of total PSA between 4.0 ng/ml and 10.0 ng/ml are often referred to as the "gray zone." No fasting is required for this laboratory screening.

CA-125 (Ovarian Cancer Screening)
The CA-125 screening is used before starting therapy for ovarian cancer, if at high risk for developing ovarian cancer, and to monitor intervals during and after treatment for ovarian cancer or to detect recurrence. CA-125 is primarily used to monitor therapy during treatment for ovarian cancer. CA-125 is also used to detect whether cancer has come back after treatment is complete. This test is sometimes used to test and monitor high-risk women who have a family history of ovarian cancer but who do not yet have the disease. This test is not used to screen for ovarian cancer because it is non-specific. Levels in the blood can be elevated in other conditions such as normal menstruation, pregnancy, endometriosis, and pelvic inflammatory disease. No fasting is required for this laboratory screening.

THE PLAC TEST
The PLAC Test is the only blood test cleared by the FDA to aid in assessing risk of both coronary heart disease and ischemic stroke associated with atherosclerosis. 87% of strokes are ischemic. The PLAC Test measures the level of Lp-PLA2, an enzyme associated with the inflammation of your arteries. Increased levels of Lp-PLA2 increase your risk of having a heart attack or stroke. In most adults, cholesterol causes a fatty deposit called plaque to build up in the walls of the arteries. When these walls become inflamed, your body produces an enzyme called Lp-PLA2. If the amount of Lp-PLA2 is high, this may indicate that the plaque is more likely to rupture through the inside lining of your artery into your blood stream, where it may cause a clot that could result in heart attack or stroke. The PLAC Test can provide you and your doctor with information about the health of your arteries that was not available in the past. In a study from the Mayo Clinic, 95% of individuals who had Lp-PLA2 levels below 200 ng/mL did not have either a heart attack or stroke over a 4-year period, even though they had coronary artery disease. It is okay to have the test done if you have taken medication. Results of the PLAC Test are not usually affected by smoking, having a cold, recent asthma attack or arthritis flare-up, the flu or other similar illnesses. Please visit www.plactest.com for more information. No fasting is required for this laboratory screening.

LEAD
The lead test is used to evaluate the concentration of lead in the blood at the time the sample was collected. The blood lead test is used to screen for exposure to harmful levels of lead. It may also be ordered to monitor the effectiveness of treatment and to confirm that lead levels are decreasing over time. Lead concentrations are monitored at the local level following State and National standards. It is used to evaluate chronic lead exposure and recent lead exposure. Blood lead tests may be used to screen people in the workplace if lead contamination is a possibility. Family members also may be screened because lead can be carried home on clothing. This testing conforms to federal and state laws for occupational exposure. There is not yet a national guideline for blood lead screening in adults as there is for children. The clinical cut-off values for elevated blood lead currently vary from state to state. According to the CDC's Adult Blood Lead Surveillance program (ABLES), a national health objective is to reduce all blood levels in adults to less than or equal to 25 micrograms per deciliter. Adults who work in industries known for lead exposure, such as smelter facilities, lead plating, auto repair, and construction, should be screened for lead exposure. Adults who have hobbies that involve lead-based paints, ceramics, or gasoline also should be tested. If a worker has an initial blood lead test result of more than 40 micrograms per deciliter, for example, testing should be done every two months until two consecutives lead tests show a blood lead level below 25 micrograms per deciliter. Higher levels call for closer monitoring. For both children and adults, lead testing may be ordered when a person's symptoms suggest potential lead poisoning. These symptoms are non-specific and may include fatigue, changes in mood, nausea, prolonged stomach distress, headache, tremors, weight loss, peripheral neuropathy, anemia, reproductive failure, encephalopathy, memory loss, seizures, and coma. The higher the test result, the more lead is in the blood. However, the amount of lead in the blood does not necessarily reflect the total amount of lead in the body. This is because lead travels from the lungs and intestinal tract to the blood and organs, and then is gradually removed from the blood and organs and stored in tissues such as bones and teeth. The danger that a particular lead level represents depends on the age and health of the person, the amount of lead they are exposed to, and the amount of time that they are exposed to elevated lead levels. For non-pregnant adults, a level below 25 micrograms per deciliter is generally considered to be acceptable. If a worker has levels above 45 micrograms per deciliter, he must be removed from lead exposure until his blood lead level drops below 40 micrograms per deciliter. Removal may also be recommended if he is symptomatic at any level below 70 micrograms per deciliter. Because lead will pass through the blood to an unborn child, pregnant women need to limit their exposure to lead to maintain a blood level below 10 micrograms per deciliter and as close to zero as possible to protect the developing fetus. Any lead level greater than 70 micrograms per deciliter, whether in a child or an adult, should be considered a medical emergency. No fasting is required for this laboratory screening.

VAP Test
The Vap Test utilizes an advanced technology that provides a more accurate, individualized picture of your heart disease and diabetes risk so that you and your doctor can take steps to prevent a future heart attack. For example, the VAP Expanded Lipid Profile measures not only the basic information provided by the routine cholesterol test, but also identifies hidden cholesterol problems that can increase your risk of developing heart disease or diabetes - even if your routine cholesterol test results are "normal." It breaks down cholesterol beyond HDL (high-density lipoprotein, the "good" cholesterol), LDL (low-density lipoprotein, the "bad" cholesterol), and triglycerides - providing new information that can help your doctor better assess and manage your heart disease risk. VAP Tests also help identify the metabolic syndrome, which leads to diabetes and heart disease, affecting a staggering 55 million Americans. As a result, the VAP Test was named one of "Ten Ways to Live Longer" by Forbes.com and was selected as one of "Five Tests Worth Paying For" by the Wall Street Journal.

Please note: All laboratory screenings are for screening purposes ONLY, and do NOT constitute a diagnosis. Please see your Physician for interpretation of all results and for consultation.

Drug Testing Menu Offered Through CWP

Oral Fluid Testing for 6 Drug Panel Screening
Included: Marijuana, Meth, Opiates, Cocaine & Phencyclidine
Oral Fluid Testing for Alcohol for additional charge

Urine Testing for 10 Drug Panel Screening:
At Lab Express's facility

Hair Testing for 5 Drug Panel Screening:
At Lab Express's facility

DOT Urine Collection & Screening:
At Lab Express's facility
Breath Alcohol for additional charge

Blood Testing 10 Panel Legal:
At Lab Express's facility

Blood Alcohol GC Testing Legal:
At Lab Express's facility

Please call for pricing. All reporting via Fax, email or mail is included in pricing.