cancer screening + prevention

Question 1

5 modifiable lifestyle factors that impact cancer risk (primary prevention)

Answer 1

smoking: cancer + CV disease + pulm disease
obesity: 70% of US is overweight or obese, ↑ insulin resistance: ↑insulin + IGF-1 (inhibit apoptosis → cancer)
high-fat diet: breast, colon, prostate, endometrial
inactivity: breast, colon
sun exposure: basal cell, squamous cell, melanoma (repeated sunburns at young age)

Question 2

breast cancer screening

Answer 2

breast self-exams: not recommended
clinical breast exam: insufficient evidence for or against
mammograms: 50-74 yo every 2 years, 75+: insufficient evidence

Question 3

cervical cancer screening

Answer 3

pap smear: 21-65 yo every 3 years, 65 +: none if normal in past, if total hysterectomy for benign reason (no cervix): no pap smears anymore

Question 4

prostate cancer screeing

slow-growing, usually die with cancer (not from cancer)

Answer 4

NO SCREENING
PSA: specific for prostate tissue (not cancer) (not recommended)
digital rectal exam: 15% cancers not palpable (no recommendation for or against)
beginning at 50, or 40-45 for high-risk (discuss options for screening with patient)

Question 5

colon cancer screening

Answer 5

colonoscopy: 50-75 yo every 10 years (identify early, remove), if history in family: begin at 40 yo or 10 years younger than family member diagnosis
fecal occult blood test: 50-75 yo annually

Question 6

lung cancer screening

Answer 6

asymptomatic + no smoke: no screening (no chest xray, CT scan)
annual chest CT in adults 55-80 yo who have 30-pack year history of smoking if still smoking or quit within last 15 years

Question 7

CA-125

Answer 7

not for screening or diagnosis

monitor response to therapy after diagnosis