280 - Cancer Screening Flashcards
D - Routine screening is not recommended
C
People 55 - 80 with 30+ pack year smoking hx who currently smoke or quit <15 years ago
Who should be screened for colon cancer?
- Age 45*-75
- *Previously 50
- Earlier if family hx is suggestive
No one screening method is recommended over another
FOBT or FIT yearly
FIT-DNA every 3 years
Colonoscopy every 10 years
CT colonography or flexible sigmoidoscopy every 5 years
C
Is it recommended to teach patients how to do breast self-exams
No
In fact, it is recommeded against!
Who should be screened for cervical cancer?
People 21-65
- 21-29
- PAP every 3 years
- 30-65 (1 of the following)
- PAP every 3 years
- CO-testing every 5 years
- hrHPV alone every 5 years
- Stopping at age 65 relies on normal PAP for the last 10 years
New guidelines are suggesting starting screening at 25 instead of 21
Which USPSTF grades recommend that we should “offer or provide this service”?
A or B
What kind of bias:
People live longer after diagnosis, but it’s because they were diagnosed early in the course of the diseae (not because the treatment works)
Lead-time bias
What are the current guidelines for breast cancer screening?
Mammogram every 2 years
- Start at age 50
- Individualize decision for 40-49
- Stop at age 74
What is the best way to avoid lead time and lenth time bias in cancer screening trials?
Use cancer-specific mortality rates
Instead of survival rates, rates of dx
A
Can use any of the following:
- FOBT or FIT yearly
- FIT-DNA every 3 years
- Colonoscopy every 10 years
- CT colonography or flexible sigmoidoscopy every 5 years
What kind of bias:
People with aggressive disease present with symptoms and die quickly, while people with indolent disease are detected on screening - this makes it look like screening is effective, when in reality it’s just detecting cancers with better prognosis
Length time bias
D
Screen people 21-65
- 21-29
- PAP every 3 years
- 30-65 (1 of the following)
- PAP every 3 years
- CO-testing every 5 years
- hrHPV alone every 5 years
- Stopping at age 65 relies on normal PAP for the last 10 years
New guidelines are suggesting starting screening at age 25 instead of 21`
Who should be screened for lung cancer?
People with all of the following:
- 55 - 80 years old
- 30+ pack year smoking hx who currently smoke or quit <15 years ago