Cancer screening programmes Flashcards
Which female gynae cancers are screened for in the UK?
Cervical cancer
Breast cancer
What is the purpose of cervical cancer screening?
To detect precancerous changes in the cervix
- i.e. cervical intraepithelial neoplasia (CIN)
What is the purpose of breast cancer screening?
To detect small tumours before they are large enough to be palpable
What are the possible causes of breast lumps?
Fibroadenoma. Breast cysts. Infection. Fat necrosis. Lipoma. Breast cancer. (also normal physiology with menstrual cycle)
How is breast cancer diagnosed?
Triple therapy;
- clinical examination
- imaging
- FNA cytology
Who is eligible for cervical screening?
Women aged 25 - 64 (must be registered with a GP otherwise will not be notified)
Who is eligible for breast screening?
Women aged 50 - 70 (must be registered with a GP otherwise will not be notified)
What are the risk factors for cervical cancer?
HPV, especially types 16 and 18 Early age at first intercourse Multiple sexual partners Prolonged oral contraceptive use Cigarette smoking STDs Immunodeficiency
What are the risk factors for breast cancer?
Family history (1st degree relatives) Genetics - BRCA1/2, TP53 genes Not breast-feeding Early menarche / late menopause Rasiation to chest Obesity, alcohol HRT
Which genes are associated with an increased risk of breast cancer?
Breast Cancer type 1 (BRCA1)
Breast Cancer type 2 (BRCA2)
Tumour protein P53 (TP53) gene
How frequently is cervical screening carried out?
Age 25-49: every 3 years
Age 50-64: every 5 years
How frequently is breast screening carried out?
Every 3 years
What is the screening test for CIN?
Cervical smear and cytology
What is the screening test for breast cancer?
Mammogram (x-ray)
2 images taken from 2 views:
- craniocaudal view
- mediolateral oblique view
Give two changes on mammography that suggest breast malignancy?
Calcifications
Lesions with high density
What happens if there is an abnormal result? (cervical screening)
If low grade dyskaryosis: - repeat in 6 months - test for HPV infection If high grade dyskaryosis: - refer to colposcopy - biopsy If CIN on biopsy --> LLETZ
What happens if there is an abnormal result? (breast cancer)
Triple assessment:
- clinical examination
- fine needle aspiration and cytology
- imaging (ultrasound first, then repeat mammography and/or MRI)
Which tumour markers are associated with breast cancer?
Cancer Antigen (CA) 27.29 Carcinoembryonic antigen (CEA) Cancer Antigen (CA) 125
Which tumour marker is associated with cervical and endometrial cancer?
Carcinoembryonic antigen (CEA)
Which tumour marker is associated with ovarian cancer?
Cancer Antigen (CA) 125
Prostate cancer is not routinely screened for in the UK, however what marker is associated with it?
PSA (prostate specific antigen)
What conditions may be associated with a raised PSA?
Acute urinary retention. Benign prostatic hyperplasia. Old age. Prostatitis. Prostate cancer. Transurethral resection of the prostate. Urinary catheterisation.
What percentage of men with prostate cancer have a normal PSA?
15%
How many men vs women are diagnosed with breast cancer per year in the UK?
350 men vs 50 000 women
