Bowel Cancer Screening Flashcards
Who is at average risk of colorectal cancer (CRC)?
Asymptomatic people with:
- No personal history of CRC/colorectal adenomas/inflammatory bowel disease or family history of CRC, OR
- ONE 1st deg relative diagnosed ≥55yrs (2 flags), OR
- ONE 1st deg (2 flags) and ONE 2nd degree relative (1 flag) diagnosed ≥55yrs
Screening for AVERAGE risk population for CRC?
iFOBT every 2yrs from 50-74
Who is at moderate risk of CRC?
Asymptomatic people with:
- ONE 1st deg relative diagnosed <55yrs (4 flags)
- TWO 1st deg relatives diagnosed at any age (2 x 2 flags = 4 flags)
- ONE 1st deg (2 flags) + ≥TWO 2nd deg relatives (2 x 2 flags = 4 flags) diagnosed at any age
FOUR flags puts you at moderate risk
Screening for MODERATE risk population for CRC?
iFOBT every 2yrs from 40-49
Colonoscopy every 5yrs from 50-74
How long should low dose aspirin be given to be protective against CRC?
Low dose aspirin 100-300mg daily for at least 2.5 years commencing at 50-70yrs to prevent CRC
Who is at high risk for CRC?
Asymptomatic people with:
- ≥THREE 1st deg/2nd deg relatives with CRC (with at least one diagnosed <55yrs)
- ≥THREE 1st deg relatives with CRC diagnosed at any age
People with high-risk familial syndromes, lynch syndrome
Family member with Lynch syndrome related cancer
People with familial polyposis syndromes
(Flag system does not apply!)
(More details in red book!)
Screening for high risk population for CRC?
iFOBT every 2yrs from 35-44yrs
Colonoscopy every 5yrs from 45-74
Refer to familial cancer centre
48 yo man with a brother diagnosed with CRC at 60yrs. What is my risk level? What screening am I due for?
Average risk
iFOBT every 2yrs from 50
Too early for aspirin
52 yo female with mother diagnosed with CRC at 54yrs, brother diagnosed at 60 yrs.
What is my risk level?
What screening is due?
Moderate risk
Colonoscopy every 5yrs starting now until 74
Aspirin for at least 2.5yrs recommended
45yo man with father diagnosed with CRC at 68yrs, aunt at 56yrs, grandfather at 70yrs.
What is my risk level?
What screening is due?
1st deg ≥55yrs = 2 flags
2nd deg ≥55yrs = 1 flag (x2)
Equals 4 flags
= moderate risk
iFOBT from 40-49, so is due for iFOBT then will start 5yrly scopes at 50
Too early for aspirin
36yo woman with father with CRC diagnosed at 65yrs, mother with endometrial cancer diagnosed at 60yrs, aunty with ovarian cancer at 65yrs
What is my risk level?
What screening is due?
High risk (CRC + lynch syndrome cancers)
Refer to familial cancer clinic for genetic risk assessment and specialist decision on frequency and starting age of colonoscopic surveillance and aspirin
44yo female with aunty and grandmother diagnosed with CRC at 57yrs and 61yrs
What is my risk level?
What screening is due?
2nd deg relative diagnosed ≥55yrs: 1 flag
1 flag x2 = 2 flags
Not met threshold for moderate risk
= average risk
iFOBT every 2yrs from 50-74
