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Oncology > Cancer Screening > Flashcards

Cancer Screening Flashcards

1
Q

Number 1 Cancer in Males

A

Prostate

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2
Q

Number 1 Cancer in Females

A

Breast

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3
Q

Number 1 Cancer that Males & Females Die from Each Year

A

Lung & bronchus

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4
Q

General Cancer Prevention

A 
Avoid tobacco
Be physically active
Maintain a healthy weight
Limit alcohol
Avoid excess sun
Eat a diet rich in fruits, veggies, & whole grains & low in sat/trans fats
Protect against STIs
Regular screening for breast, cervical, & colorectal cancer
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5
Q

Principles of Screening

A

Disease has high prevalence
Disease has serious consequences
Detectable pre-clinical phase
Treatment for pre-symptomatic disease more effective than after symptoms develop
Positive impact on clinical health outcomes

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6
Q

Other Considerations for General Screening

A

What are patient’s co-morbid conditions?
Associated life expectancy, feasibility of treatment, effects of treatment on QOL?
What will you do with the results?

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7
Q

Which cancers are largely asymptomatic in the early stages?

A

Colorectal
Breast
Cervical

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8
Q

What is the leading cause of death from gynecologic malignancy in the U.S.?

A

Ovarian cancer

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9
Q

Pelvic Examination in Ovarian Cancer

A

No evidence they reduce mortality
Early stage tumors rarely found
Usually detected at an advanced stage & associated with a poor prognosis

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10
Q

Screening for Ovarian Cancer

A

CA 125 & TVUS
Family ovarian cancer syndrome or BRCA genes: CA 125 & TVUS
Initiation at 35 years or 5-10 years earlier than earliest age of first diagnosis

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11
Q

BRCA1 Carriers & Breast, Ovarian, & Contralateral Breast Cancer Risk

A

Breast risk: 60%
Ovarian risk: 59%
Contralateral breast risk: 83%

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12
Q

BRCA2 Carriers & Breast, Ovarian, & Contralateral Breast Cancer Risk

A

Breast risk: 55%
Ovarian risk: 16.5%
Contralateral breast risk: 62%

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13
Q

When to Test for BRCA for Non-Ashkenazi Jewish Women

A

2 1st-degree relatives with breast cancer, one

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14
Q

When to Test for BRCA for Women of Ashkenazi Jewish Descent

A

1st degree relative with breast or ovarian CA

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15
Q

Positive Impact on Clinical Health Outcomes for Ovarian Cancer

A

Annual pelvic, CA-125, and TVUS DO NOT decrease mortality from ovarian cancer

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16
Q

Prevention of Ovarian Cancer

A

Oral contraceptives
Gynecologic surgery: tubal, hysterectomy
Pregnancy
Breastfeeding

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17
Q

Cervical Cancer Prevention

A

Pap test

Death rate decreased 50% since pap administration

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18
Q

Cervical Cancer Screening Recommendations

A

Women should begin screening at age 21 unless HIV or immunocompromised
21-29 cytology every 3 years
30 years old: cytology every 3 years, co-testing cytology & HPV testing every 5
May stop after 65 if adequate screening in past 10 years with 2 negative screens

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19
Q

High Risk Groups for Cervical Cancer

A

Patients with HIV infection
Patients who are immunosuppressed
Those who had in utero DES exposure
Women who have been treated for CIN2, CIN3, or cervical cancer

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20
Q

Cervical Cancer: Hysterectomy Patients who Still Need Pap Smears

A

Surgery was done as treatment for cervical CA or pre-cancer

Hysterectomy without removal of the cervix

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21
Q

Cervical Cancer Prevention

A

Gardasil
Avoid exposure to HPV
Don’t smoke
Pap smear

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22
Q

Epidemiology of Breast Cancer

A

Most common in U.S
Second leading cause of cancer death in women
Diagnosed as a result of abnormal screening study

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23
Q

Primary Risk Factors for Breast Cancer

A

Predominantly in females

Age: 85% age 50+

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24
Q

Screening Tools for Breast Cancer

A

Mammography
Ultrasound
MRI: high risk patients

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25
Q

Proper Clinical Breast Exam (CBE) Technique

A

Flatten breast tissue against chest
Examine in vertical strips
Make circular motions with pads of the middle 3 fingers
Examine each breast with 3 different pressure for at least 3 minutes

26
Q

Epidemiology of Colorectal Cancer

A

3 most common cancer in U.S.

2nd leading cause of cancer-related deaths in U.S.

27
Q

Assess Colorectal Cancer Risk

A

Start at age 20 & every 5 year thereafter
Have you ever had colorectal cancers or an adenomatous polyp?
Have you had inflammatory bowel disease?
Have any family members had CBC or adenomatous polyp? If so, how many were 1st degree relatives & at what age was cancer or polyp diagnosed?

28
Q

Recommendations

A

Fecal occult blood test: begin at 50
Flexible sigmoidoscopy: begin at 50, every 5 years; + sensitive FOBT every 3 years
Colonoscopy: begin at 50, every 10 years
Virtual colonoscopy: every 5 years

29
Q

FOBT

A 
Finds blood in the stool (3 samples)
Stool guaiac
Immunochemical stool tests
Check for some intestinal conditions or colorectal cancer
\+ test = colonoscopy
30
Q

Sigmoidoscopy

A

View rectum, sigmoid, and last 2 feet of large intestine

Biopsies can be taken

31
Q

Risks of Sigmoidoscopy

A

Bleeding from site where biopsy was taken

Tear in colon or rectum wall

32
Q

Drawbacks of Sigmoidoscopy

A

Cannot see entire colon

Proximal lesions may not be seen

33
Q

Define Colonoscopy

A

Endoscopic exam of the colon AND the distal part of the small bowel with a fiber optic camera on a flexible tube passed through the rectum

34
Q

Positives of a Colonoscopy

A

Visual diagnosis

Opportunity for biopsy or removal of lesions

35
Q

Complications of Colonoscopy

A

Bleeding from biopsy site

Tear in the colon or rectum wall

36
Q

CDC Colorectal Cancer Control Program

A

Colorectal CA screening services to low-income men & women aged 50-64
Program sites also provide diagnostic follow-up

37
Q

Screening for High Risk Populations

A

Family history
Family adenomatous polyposis (FAP)
Hereditary non-polyposis colon cancer (HNPCC)

38
Q

Screening for High Risk Populations: History of Adenomatous Polyps

A

Colonoscopy age 40 or 10 years prior to earliest diagnosis; repeat every 5 years
Based on pathology & # of adenomas
Adenoma with high grade dysplasia- repeat in 3 years
1-2 small tubular adenomas with low grade dysplasia- repeat in 5 years

39
Q

Screening for High Risk Populations: Family Adenomatous Polyposis

A

Sigmoidoscopy starting at age 10-12

40
Q

Screening for High Risk Populations: Hereditary Non-Polyposis Colon Cancer

A

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

41
Q

Virtual Colonoscopy

A

Uses a CT scanner to take images of the entire bowel

2D & 3D

42
Q

PROs of Virtual Colonoscopy

A

Doesn’t require sedation
Non-invasive
Entire bowel can be examined

43
Q

CONs of Virtual Colonoscopy

A

Abnormality will need colonoscopy

44
Q

Epidemiology of Prostate Cancer

A

Most common cancer in men
Mainly in older men
2nd leading cause of cancer death in U.S. men

45
Q

Screening Tests for Prostate Cancer

46
Q

DRE Testing in Prostate Cancer

A

Can detect 85% of tumors

Doesn’t show reduction in morbidity or mortality

47
Q

PSA Screening Prostate CA

A

Give men the pros & cons and let them make their own screening diagnosis

48
Q

Potential Benefits of Prostate Cancer Screening

A

Detect cancers early
Treatment more effective when it is found early
5-year survival with localized cancer 100%

49
Q

Potential Risks of Prostate Cancer Screening

A

False positive test results lead to further tests
Potential SE: infection from biopsies
Treatment may have never affected a man’s health if left untreated

50
Q

Complications of Prostate Cancer Treatment

A

Sexual dysfunction
Urinary incontinence
Bowel dysfunction

51
Q

Screening in Regular Risk Men

A

Age 50 unless life expectancy

52
Q

Screening in High Risk Men

A

Age 40
African American men
Family history of prostate CA esp.

53
Q

Screening Guidelines for Lung Cancer for People at High Risk

A

55-74 years old
Fairly good health
At least 30 pack year history, still smoking, having quit last 15 years

54
Q

Recommend Screening for Lung Cancer

A

Method: LDCT scan
Location: center that can accurately do scans; expertise to interpret & advise the patient
Risk: unnecessary biopsies, partial removal of lung

55
Q

Principles of Lung Cancer Screening

A 
Disease has high prevalence
Disease has serious consequences
Detectable preclinical phase
Treatment for pre-symptomatic disease more effective than after symptoms develop
Screening reduces cancer mortality
56
Q

High Prevalence of Lung Cancer

A

2nd most common cancer in the US

57
Q

Serious Consequences of Lung Cancer

A

1 cause of cancer mortality

58
Q

Prevention of Lung Cancer

A

Smoking cessation

59
Q

Prevention of Skin Cancer

A

Wear sunscreen

Don’t use tanning beds

60
Q

Factors that Effectiveness Depends on for Skin Cancer

A

Whether clinician can identify early stage disease
Whether pathologist can accurately diagnose & histologically stage disease
Whether tumor is identified at a stage where treatment would be effective
Whether tumor identified by screening would become clinically meaningful

61
Q

Epidemiology of Oral Cancers

A

Men > Women

Oropharyngeal CA linked with HPV

Oncology (11 decks)

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