FHIR IG analytics| Package | smart.who.int.cxca |
| Resource Type | Questionnaire |
| Id | Questionnaire-QCXCAD1.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/dhes/smart-dak-cxca/Questionnaire-QCXCAD1.html |
| URL | http://smart.who.int/cxca/Questionnaire/QCXCAD1 |
| Version | 0.0.1 |
| Status | draft |
| Date | 2026-05-14T00:50:23+00:00 |
| Title | QCXCAD1 — Cervical Cancer Screening Anamnesis |
| Description | Questionnaire that captures the cervical cancer screening anamnesis required by Mongolia MOH Order A/641 (2020) Op.Inst. 5.1. Paired with CXCAD1 LogicalModel; linkId values match LogicalModel element names so a StructureMap-based extraction can be authored mechanically. |
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire QCXCAD1
Language: en
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | Questionnaire that captures the cervical cancer screening anamnesis required by Mongolia MOH Order A/641 (2020) Op.Inst. 5.1. Paired with CXCAD1 LogicalModel; linkId values match LogicalModel element names so a StructureMap-based extraction can be authored mechanically. | Questionnaire | http://smart.who.int/cxca/Questionnaire/QCXCAD1#0.0.1 | |
  clientAge | Client's age in years on the encounter date | 1..1 | integer | |
 clientEducation | Highest level of education completed | 0..1 | string | |
| numberOfPregnancies | Total number of pregnancies (any outcome) | 0..1 | integer | |
| numberOfBirths | Number of live births | 0..1 | integer | |
 lastMenstrualPeriod | First day of the client's most recent menstrual period | 0..1 | date | |
 currentlyPregnant | Is the client currently pregnant? | 0..1 | boolean | |
| gestationalAgeWeeks | If currently pregnant, gestational age in weeks | 0..1 | integer | Enable When: currentlyPregnant = true |
| currentContraception | Current contraception method | 0..1 | string | |
| pastContraception | Past contraception methods used | 0..1 | string | |
| ageAtFirstSexualContact | Age at first sexual contact | 0..1 | integer | |
| ageAtFirstDelivery | Age at first delivery (if any) | 0..1 | integer | |
| numberOfSexualPartners | Lifetime number of sexual partners | 0..1 | integer | |
| hasHadSTI | Has the client ever had a sexually transmitted infection? | 0..1 | boolean | |
 hivStatus | HIV status | 0..1 | choice | Options: 3 options |
| currentlyOnART | If HIV-positive, currently on antiretroviral therapy? | 0..1 | boolean | Enable When: hivStatus = HIV-positive (CXCA Data Dictionary#DE17) |
| lastScreeningDate | Date of most recent prior cervical cancer screening (leave blank if never) | 0..1 | date | |
| lastScreeningType | Type of most recent prior screening | 0..1 | choice | Options: 3 options |
| lastScreeningResult | Result category of most recent prior screening | 0..1 | choice | Options: 3 options |
| hadHysterectomy | Has the client had a hysterectomy? | 0..1 | boolean | |
| hysterectomyForCervicalCancer | If yes, was the hysterectomy for cervical cancer? | 0..1 | boolean | Enable When: hadHysterectomy = true |
| smokingStatus | Smoking status | 0..1 | choice | Options: 3 options |
| alcoholUse | Does the client consume alcohol regularly? | 0..1 | boolean | |
| hasPostcoitalBleeding | Bleeding after intercourse? | 0..1 | boolean | |
| hasIntermenstrualBleeding | Bleeding between menstrual periods? | 0..1 | boolean | |
 hasUnusualDischarge | Unusual vaginal discharge? | 0..1 | boolean | |
| Documentation for this format | ||||
Options Sets
Answer options for hivStatus
Answer options for lastScreeningType
Answer options for lastScreeningResult
Answer options for smokingStatus
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "QCXCAD1",
"language": "en",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://smart.who.int/cxca/Questionnaire/QCXCAD1",
"version": "0.0.1",
"title": "QCXCAD1 — Cervical Cancer Screening Anamnesis",
"status": "draft",
"experimental": false,
"subjectType": [
"Patient"
],
"date": "2026-05-14T00:50:23+00:00",
"publisher": "Dan Heslinga (independent contributor)",
"contact": [
{
"name": "Dan Heslinga (independent contributor)",
"telecom": [
{
"system": "url",
"value": "https://github.com/dhes"
}
]
}
],
"description": "Questionnaire that captures the cervical cancer screening anamnesis required by Mongolia MOH Order A/641 (2020) Op.Inst. 5.1. Paired with CXCAD1 LogicalModel; linkId values match LogicalModel element names so a StructureMap-based extraction can be authored mechanically.",
"item": [
{
"linkId": "clientAge",
"text": "Client's age in years on the encounter date",
"type": "integer",
"required": true
},
{
"linkId": "clientEducation",
"text": "Highest level of education completed",
"type": "string",
"required": false
},
{
"linkId": "numberOfPregnancies",
"text": "Total number of pregnancies (any outcome)",
"type": "integer",
"required": false
},
{
"linkId": "numberOfBirths",
"text": "Number of live births",
"type": "integer",
"required": false
},
{
"linkId": "lastMenstrualPeriod",
"text": "First day of the client's most recent menstrual period",
"type": "date",
"required": false
},
{
"linkId": "currentlyPregnant",
"text": "Is the client currently pregnant?",
"type": "boolean",
"required": false
},
{
"linkId": "gestationalAgeWeeks",
"text": "If currently pregnant, gestational age in weeks",
"type": "integer",
"enableWhen": [
{
"question": "currentlyPregnant",
"operator": "=",
"answerBoolean": true
}
],
"required": false
},
{
"linkId": "currentContraception",
"text": "Current contraception method",
"type": "string",
"required": false
},
{
"linkId": "pastContraception",
"text": "Past contraception methods used",
"type": "string",
"required": false
},
{
"linkId": "ageAtFirstSexualContact",
"text": "Age at first sexual contact",
"type": "integer",
"required": false
},
{
"linkId": "ageAtFirstDelivery",
"text": "Age at first delivery (if any)",
"type": "integer",
"required": false
},
{
"linkId": "numberOfSexualPartners",
"text": "Lifetime number of sexual partners",
"type": "integer",
"required": false
},
{
"linkId": "hasHadSTI",
"text": "Has the client ever had a sexually transmitted infection?",
"type": "boolean",
"required": false
},
{
"linkId": "hivStatus",
"text": "HIV status",
"type": "choice",
"required": false,
"answerOption": [
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE17",
"display": "HIV-positive"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE18",
"display": "HIV-negative"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE19",
"display": "HIV status unknown"
}
}
]
},
{
"linkId": "currentlyOnART",
"text": "If HIV-positive, currently on antiretroviral therapy?",
"type": "boolean",
"enableWhen": [
{
"question": "hivStatus",
"operator": "=",
"answerCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE17"
}
}
],
"required": false
},
{
"linkId": "lastScreeningDate",
"text": "Date of most recent prior cervical cancer screening (leave blank if never)",
"type": "date",
"required": false
},
{
"linkId": "lastScreeningType",
"text": "Type of most recent prior screening",
"type": "choice",
"required": false,
"answerOption": [
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE23",
"display": "Past screening: HPV high-risk DNA test"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE24",
"display": "Past screening: cytology only"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE25",
"display": "Past screening: VIA (visual inspection with acetic acid)"
}
}
]
},
{
"linkId": "lastScreeningResult",
"text": "Result category of most recent prior screening",
"type": "choice",
"required": false,
"answerOption": [
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE26",
"display": "Past screening: normal / negative"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE27",
"display": "Past screening: abnormal / positive"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE28",
"display": "Past screening: result unknown"
}
}
]
},
{
"linkId": "hadHysterectomy",
"text": "Has the client had a hysterectomy?",
"type": "boolean",
"required": false
},
{
"linkId": "hysterectomyForCervicalCancer",
"text": "If yes, was the hysterectomy for cervical cancer?",
"type": "boolean",
"enableWhen": [
{
"question": "hadHysterectomy",
"operator": "=",
"answerBoolean": true
}
],
"required": false
},
{
"linkId": "smokingStatus",
"text": "Smoking status",
"type": "choice",
"required": false,
"answerOption": [
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE20",
"display": "Current smoker"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE21",
"display": "Former smoker"
}
},
{
"valueCoding": {
"system": "http://smart.who.int/cxca/CodeSystem/CXCA.D",
"code": "DE22",
"display": "Never smoker"
}
}
]
},
{
"linkId": "alcoholUse",
"text": "Does the client consume alcohol regularly?",
"type": "boolean",
"required": false
},
{
"linkId": "hasPostcoitalBleeding",
"text": "Bleeding after intercourse?",
"type": "boolean",
"required": false
},
{
"linkId": "hasIntermenstrualBleeding",
"text": "Bleeding between menstrual periods?",
"type": "boolean",
"required": false
},
{
"linkId": "hasUnusualDischarge",
"text": "Unusual vaginal discharge?",
"type": "boolean",
"required": false
}
]
}