Cancer Prevention in Adults & Chemoprophylaxis

Question 1

Organize by ranking the 5 most common types of cancers for women

Answer 1

1. Breast cancer
2. Colorectal cancer
3. Endometrial cancer
4. Lung cancer
5. Cervical cancer

Question 2

Organize by ranking the 5 most common types of cancers for men

Answer 2

1. Prostate cancer
2. Colorectal cancer
3. Lung cancer
4. Skin cancer
5. Anal cancer

Question 3

Identify the most common cancer leading to death for both men and women.

Answer 3

Lung cancer

Question 4

Describe abnormal findings on the clinical breast examination that could indicate the presence of breast cancer.

Answer 4

Most comomon= new lump or mass

• Painless, hard, irregular edges
• But can also be soft, round, tender, or even painful

Other possible sx

• Swelling of all or part
• Skin dimpling
• Breast or nipple pain
• Nipple retraction
• Nipple or breat skin: red, dry, flaky, thickened
• Nipple discharge (not milk)
• Swollen lymph nodes in axillary or clavicle region

Question 5

Explain the recommended screening for colorectal cancer according to the USPSTF and further outline recommended follow-up intervals.

Answer 5

Starting at age 50 and continuing until 75 years
- Screening in ages 76 to 85 years should be based on pt’s overall health and screening history.

Follow-up intervals

• High sensitivity gFOBT or FIT every year
• sDNA-FIT every 1 to 3 years
• CT colonography every 5 years
• Flexible sigmoidoscopy every 5 years (Every 10 years + FIT every year)
• Colonoscopy every 10 years

Question 6

Identify the recommendations for cervical cancer screening and further explain the timing and intervals for such screening.

Answer 6

• Evidence from RCTs, observational studies, modeling studies suggest→ 5 year screening interval for primary hrHPV testing alone or cotesting offers the best balance of benefits and harms
• Screening more frequently than every 5 years with primary hrHPV testing alone or cotesting does not substantially improve benefit but significantly increases the number of screening tests and colposcopies.

Question 7

Define PSA, the normal value, and describe the relevance of the PSA velocity

Answer 7

• PSA= Prostate-specific antigen
• Normal value= 1.0-1.5 ng/ml (A PSA score may be considered abnormal if it rises a certain amount in a signal year. Rises >0.35 ng/ml in a single year= needs further testing)
• Men 40s to 50s= PSA score >2.5 ng/ml abnormal for age (Median is 0.6 to 0.7)
  Men in 60s= >4.0 ng/ml is abnormal