Common cancers Flashcards
When to refer women to genetic clinic about breast cancer
- 1 1st degree relative: diagnosed <40y, male, bilateral with first <50y
- two 1st degree or one 1st and one 2nd degree relatives
- 1 1st/2nd degree relative + 1 1st/2nd degree relative with ovarian cancer
- consider: Jewish + FHx
Breast cancer screening
- mammography
- women aged 50-70
- every 3 years
Cervical cancer screening
- HPV testing/liquid based cytlogy
- women aged 25-64
- every 3 years: 25-49
- every 5 years: 49-64
- referred to colposcopy if abnormal
What do faecal occult blood and faecal immunochemical testing involve?
FOB: 3 stool samples on 3 separate occasions
FIT: 1 stool sample
Bowel cancer screening
- one-off flexible sigmoidoscomy at 55y to identify and remove polyps
- faecal occult blood (FOB)
- men and women aged 60-74 (>74s can request by calling hotline)
- every 2 years
Referral criteria for suspected breast cancer
2WW:
- > 30 with unexplained breast lump
- > 50 with unilateral nipple Sx or other changes of concern
- consider: skin changes, >30 with unexplained lump in axilla
Consider non-urgent ref:
- <30 with unexplained lump
Referral criteria for suspected colorectal cancer
2WW:
- 40+ with unexplained weight loss AND abdo pain
- 50+ with unexplained rectal bleeding
- 60+ with iron-deficiency anaemia OR change in bowel habit
- age age with FOB on screening
Consider 2WW:
- rectal or abdominal mass
- <50 with rectal bleeding AND one of: abdo pain, change in bowel habit, weight loss, iron-deficiency anaemia
Offer FOB testing in those without rectal bleeding but with Sx that do not meet criteria for referral, or if 60+ with any type of anaemia
Referral criteria for suspected lung cancer (tip: 4 levels of urgency/types of referral)
Immediate ref/urgent admission:
- signs of SVC obstruction - swollen neck/face with fixed elevation of JVP
- stridor
2WW:
- CXR findings suggesting lung Ca
- 40+ with unexplained haemoptysis
Urgent 2W CXR:
- 2 of: cough, fatigue, SOB, chest pain, weight loss, appetite loss
- or 1 of the above if they have ever smoked
- if metastasis from lung Ca suspected
Consider urgent CXR in >40s with:
- persistent/recurrent chest infections
- clubbing
- supraclavicular lymphadenopathy
- persistent cervical lymphadenopathy
- chest signs consistent with lung Ca
- thrombocytosis
When can PSA be performed (practically)?
- once UTI excluded
Postpone until:
- 1 month after treatment of proven UTI
- 1 week after PR exam
- 3 days after ejaculation
When to examine prostate and ?do PSA
- Sx of enlarged prostate (LUTS)
- Sx of local spread - erectile dysfunction, visible haematuria
- Sx of metastasis - lower back pain, bone pain, weight loss
Referral criteria for suspected prostate cancer
2WW:
- prostate feels malignant on PR
- PSA above age-specific reference range
What to do if brain cancer suspected
order MRI/CT head (most GPs can access)
