Diabetes, aortic aneurysm and cancer screening Flashcards
Health screenings
- Screening programmes are coordinated services for a defined population
- All screening programmes do harm
- Most screening programmes do considerable good
- They have to do goof at a reasonable cost
- Being screened is a voluntary decision
Screening
Identifying apparently healthy people who may be at increased risk
Prevalence
Number of people with condition
Sensitivity
Screen’s ability to detect people who have condition
Specificity
Screen’s ability to not detect people without condition
Criteria for screening programme
1) Condition should be important, treatable health problem
2) Accepted treatment for disease
3) Available facilities for diagnosis
4) Recognisable latent or early symptomatic phase
5) Suitable test or examination
6) Test is acceptable to population
7) Natural history of condition well understood
8) Agreed policy on who to treat
9) Cost of case findings should be economically balanced in relation to expenditure on medical care
10) Case-finding should be continuing process
Diabetic eye screening
- 80% screen each year from age 12 onwards
- Pregnant women more at risk
- Tests offered at antenatal clinic visits
- If early stages are found, another test at 16-20 weeks
- Screening is important but it is treatable but very prevalent
Abdominal aortic aneurysm screening programme
- Men over 65 years old
- Run probe along aorta and identify changes in diameter
- Six times more common in men than women
- Risk factors = smoking, high BP, family risk
Most common cancer in UK
Breast
Risk factors for breast cancer
- Being female
- Increasing age
- Previous history of cancer
- Benign tumour in past
- Not breastfeeding long term
- No children
- Early puberty
- Late menopause
- Obesity
- Lots of alcohol
Breast cancer screening
- 2 film mammography
- Digital film
- 47 to 73 years
- 9 mammograms per woman
- Some women may need biopsy
Treatment for breast cancer
- Surgery - lumpectomy or mastectomy
- Surgery followed by radiotherapy and chemotherapy or a mixture
Cervical screening
- Between 25 and 64 invited every 3 years
- HPV vaccination for b and g
- HPV calls found in most cases
- Smoking doubles risk
- Triage screening: if sample shows borderline changes, it is tested for HPV. If this is found, the woman is invited for colposcopy but if no HPV found goes back to normal
Treatment for cervical cancer
- Cells destroyed using lasers
- Hysterectomy not usually necessary
- Aims to preserve fertility
- Surgery is main form of treatment followed by chemo and radiotherapy
Bowel cancer screening
- Detects early stage polyps
- Needs early detection, high uptake, effective treatment
- Risk factors: radiation, alcohol, smoking, meat, asbestos, parasites, fat
- Test 60-74 year olds by patient applying faecal sample to Guaiac FOBt kit
- Faecal immunochemical testing: as reliable as hospital test, home testing, detects blood, increased accuracy
- Sigmoidoscopy: removal of polyps, incidence decreased, safe and long lasting benefit
