Cancer prevention

Question 1

What is cancer prevention?

Answer 1

Cancer prevention is action taken to lower the risk of getting cancer

Question 2

What are the 3 steps in cancer prevention?

Answer 2

1. Primary prevention: promotion of health and wellness and reduction of risks known to contribute to cancer development
2. Secondary prevention: screening and early detection
3. Tertiary prevention: preventing recurrence or relapse in cancer and improving morbidity

Question 3

What are 3 examples of primary preventions?

Answer 3

1. Reducing risk factors: smoking, alcohol, BMI, etc.
2. Vaccines against viral infections
3. Chemoprevention to high-risk individuals

Question 4

What is chemoprevention and for who is it for?

Answer 4

Using substances to stop cancer from developing
=> people who are at high risk of developing cancer (inherited cancer risk factors, family history of cancer, etc.)
=> People who have already had cancer, lower the risk of recurrence or new cancers

Question 5

What is Tamoxifen and what is the use?

Answer 5

• It is a chemopreventive drug and it lowers the risk of breast cancer and recurrence
• It has low side effects
• It shows a reduction of mammographic density
• Possible to use with low doses (2.5mg) and have good effect
• Best response to pre-menopausal women

Question 6

What are 2 examples of secondary prevention?

Answer 6

1. Screening for cancer: checking for the presence of disease in populations at risk
2. Early detection: testing for cancer when no symptoms are present

Question 7

Why is secondary prevention important?

Answer 7

Detect cancer at the earliest possible stage => Increase chance of being successfully treated

Question 8

What screening is used for breast cancer and to what population?

Answer 8

• Mammography
• All women between ages 40-74

Mammography screening reduces the death of breast cancer with >30%
Majority of all breast cancer are detected through screening

Question 9

What screening is used for cervical cancer and to what population?

Answer 9

• Pap-smear: cytology of cervix sample and HPV analysis

- All women age 23-64

Question 10

What screening is used for prostate cancer and what is the problem with it?

Answer 10

• PSA (Prostate Specific Antigen) blood sample
• Not specific enough yet => false positivity

Prostate cancer is the most common form of cancer for men

Question 11

What screening is used for colon cancer and to what population?

Answer 11

• Screening by stool sample to detect blood and presence of tumor
• Screening for all men and women age 60-74

Question 12

What are 2 examples of tertiary prevention?

Answer 12

1. Treatment to reduce recurrence

2. Health-improving lifestyle changes

Question 13

What are the strongest risk factors for breast cancer?

Answer 13

• Female sex
• Age
• BRCA1/2 carriership
• High breast tissue density

Question 14

What do you normally find in a mammographic density?

Answer 14

• Epithelium (5% only)
• Stroma (holds the epithelium in place)
• Fatty tissue (most abundant)

Question 15

What is BI-RADS scores (A - D) in mammographic density?

Answer 15

Increase of BI-RADS = increase in breast cancer risk, BI-RADS score D = very high risk (A = very low)

Young woman have BI-RADS score D but it is normal (big tits), with time it gets very fatty and goes to BI-RADS score A => that is why breast cancer screening starts at 40 years old