Cancer Screening

Question 1

What are the necessary components for a particular cancer to be screened?

Answer 1

high prevalence, serious consequences, detectable preclinical phase, effective tx for presymptomatic disease

Question 2

Survival rate of colorectal, breast, and cervical cancer if detected and treated when the cancer is still localized

Answer 2

90% 5yr survival rate

Question 3

These are detectable in the preclinical phase of colorectal cancer

Answer 3

polyps

Question 4

What are the recommendations for a colonoscopy?

Answer 4

Every 10 years, beginning at age 50

Question 5

a thin, flexible sigmoidoscope is inserted into the rectum. examines the lower third of the colon

Answer 5

sigmoidoscopy

Question 6

examines entire colon and distal part of small bowel. allows opportunity for removal of lesions

Answer 6

colonoscopy

Question 7

What are screening recommendations if you have a 1st degree relative diagnosed with colon CA before age 60 or 2 1st degree relatives at any age?

Answer 7

Screening colonoscopy age 40 or 10 years prior to earliest family diagnosis. Repeat screen every 5 years

Question 8

What are screening recommendations for familial adenomatous polyposis?

Answer 8

Annual sigmoidoscopy starting age 10-12

Question 9

What are screening recommendations for Hereditary nonpolyposis colon cancer?

Answer 9

Colonoscopy q1-2 years beginning age 20-25 or 10 years prior to earliest CA diagnosis in family

Question 10

What are colonoscopy recommendations if past screenings have shown any adenoma w/high grade dysplasia or villous features, or multiple adenomas (≥3)

Answer 10

repeat colonoscopy in 3 yrs

Question 11

What are colonoscopy recommendations if past screenings have shown 1-2 small (<1cm) tubular adenomas w/ low grade dysplasia only?

Answer 11

Repeat colonoscopy in 5 years-10 years

Question 12

When do the majority of breast cancers occur?

Answer 12

after women reach 50 yrs of age

Question 13

At what age are mammograms recommended?

Answer 13

beginning at age 50. start talking with patients at age 40

Question 14

American cancer society recommendations for cervical cancer screening

Answer 14

screening at age 21 unless they have HIV or are immunocompromised. cytology only every 3 yrs

Question 15

When can women stop having pap smears?

Answer 15

after 65 if adequate screening in the past 10 years w/ 2 negative screens. otherwise age 75

Question 16

T/F women who have had a hysterectomy without removal of the cervix do not need pap smears

Answer 16

false. only women who have had total hysterectomy (removal of uterus and cervix) may choose stop having paps, unless it was done to tx cervical cancer/pre-cancer

Question 17

Complications of prostate cancer tx

Answer 17

sexual dysfxn, urinary incontinence, bowel dysfxn

Question 18

Can detect tumors in the posterior and lateral aspects of the prostate. Cannont detect those that are not peripheral or are stage T1

Answer 18

digital rectal examination

Question 19

T/F A negative digital rectal exam does NOT reduce the morbidity or mortality of prostate

Answer 19

true

Question 20

When is a digital rectal exam recommended?

Answer 20

only if a man is symptomatic

Question 21

At what PSA level will 42-64% of patients have prostate CA?

Answer 21

> 10ng/mL

Question 22

At what PSA levels are cancers organ confined and potentially curable, but associated with a high false-positive rate?

Answer 22

4-10ng/mL

Question 23

Screening age recommendations for prostate cancer

Answer 23

discussion begun at age 50. PSA level checked every 2-4yrs. Stop when man has less than 10yr life expectancy

Question 24

Screening guidelines for people at risk of lung cancer

Answer 24

55-74 yrs or with 30 pack yr h/o should have LDCT