Cancer Screening Presentation

Question 1

What are the ideal disease characteristics when considering what diseases to screen for?

Answer 1

1. must have a significant effect on quality or length of life (otherwise why bother?)
2. Prevalence should be high enough to justify cost
3. There should be an effective and acceptable treatment available
4. There should be an asymptomatic period during which detection and treatment significantly reduce morbidity and mortality

Question 2

What should be the ideal test characteristics when considering a screening test?

Answer 2

1. sensitive enough to detect disease during the asymptomatic period
2. specific enough to minimize false positives
3. acceptable to patients

Question 3

What are ideal characteristics of the population being screened?

Answer 3

1. sufficiency high disease prevalence
2. follow-up care possitlve
3. willing to subsequent diagnostic tests and necessary therapy

Question 4

What are some potential biases that favor screening?

Answer 4

1. Lead-time bias (diagnose a disease way early, so looks like you’re doing a great thing but disease was never going to be an issue)
2. Length-Time bias (will detect more slow-growing tumors than fast-growing tumors)
3. Overdiagnosis Bias
4. Screening Bias (healthy volunteers)

Question 5

What kind of study will minimize these biases?

Answer 5

RCTs that examine disease-specific or all-cause mortality

Question 6

What are the top four cancers in women in order?

Answer 6

lung
breast
colon
pancreas

Question 7

What are the top four cancers in men in order?

Answer 7

Lung
prostates
colon
pancreas

Question 8

In general, what are patient’s expectations of screening and preventative treatment?

Answer 8

1. they overestimate the benefits

2. their minimal acceptable benefit is must higher than the actual benefit they’ll receive