Diabetes, Aortic Aneurysm and Cancer Screening

Question 1

what is screening

Answer 1

Screening is a process of identifying apparently healthy people who may be at increased risk of a disease or condition.

They can then be offered information, further tests and appropriate treatment to reduce their risk and or any complications arising from the disease or condition

Question 2

what is prevalence

Answer 2

Prevalence is the number of individual within given population with target condition

Question 3

what is sensitivity

Answer 3

Sensitivity the screens ability to refer ( for further assessment) individuals who do have the target condition

Question 4

what is specificity

Answer 4

Specificity the measure of the screens ability to not refer individuals without the target condition

Question 5

false postive

Answer 5

False positives - individuals who are referred for further assessment but do not have the target condition

Question 6

false negative

Answer 6

False negatives individuals who are not referred for further assessment but do have the target condition

Question 7

Guide to planning a screening programme - wilson and jungner pointers

Answer 7

The condition sought should be an important health problem that is treatable
Accepted treatment for the recognised disease
Available facilities for diagnosis of this condition
Recognisable latent or early symptomatic phase
Suitable test or examination
The test must be acceptable to the population
Natural history of the disease well understood
Agreed policy on whom to treat
The cost of case finding ( diagnosis and treatment) should be economically balanced in relation to expenditure on medical care
Case finding should be a continuing programme

Question 8

who are at an increased risk of diabetes and diabetic eye

Answer 8

pregnant women

early stage type 1 and 2 - can have laser treatment too to slow down rate of deterioration

Question 9

what screening is offered for diabetes

Answer 9

Additional tests for diabetic retinopathy will be offered at or soon after first antenatal clinic visit also after 28 weeks
If early stages of retinopathy found at first screening the woman will also be offered another test between 16 and 20 week of pregnancy

Question 10

what is Abdominal aortic aneurysm (AAA) screening

Answer 10

checking whether bulge or swelling in the aorta

Question 11

what is the average size of ascending abdominal aorta

Answer 11

1.8cm

Question 12

what is the most common cancer in the UK

Answer 12

breast

Question 13

risk factors for breast cancer

Answer 13

Female 
Age 
Previous history 
Not breastfeeding long term 
Use of hormone replacement 
Obseidt 
Alcohol 
Having children at late ages 
Earl Puberty 
genetic risk factors - Two breast cancer genes identified BRCA1and 2 - only 5% of cases derive from these genes 
Cacner screening breast 
2 view mammography 
Digital film 
Current age range is 47-73 
9 per women 
Some women may need biopsy

Question 14

treatment for breast cancer

Answer 14

A lumpectomy or a mastectomy where the whole breast is removed
Surgery is likely to be followed by radiotherapy, chemotherapy or hormone therapy or a mixture of these
The exact course of treatment will depend on the type of cancer found and the woman’s personal preferences

Question 15

cervical cancer risk is reduced by what

Answer 15

HPV vaccination

Human papillomavirus

Question 16

what is HPV triage screening

Answer 16

if a screening results shows borderline changes or lowgrase dyskaryosis( abnormal cell changes) , the screening sample is tested for HPV. If HPV is found the woman is invited for colposcopy , which is a closer look at the cervix to see if any treatment is needed. If no HPV is found the woman goes back to regular screening every 3-5years depending on age

Question 17

what kind of treatment is available for cervical cancer

Answer 17

laser ablation ot destroy abnormal cells or cold coagulation or be cut away using loop diathermy or laser excision

Hysterectomy(womb) not usually necessary
radiotherapy and chemo used in extreme cases

all screening try to detect an early age

Question 18

in addition to cancer screening for bowels what else can they detect

Answer 18

Bowel cancer screening can also detect polyps
Polyps are not cancers but may develop into cancers achieving these aims is dependent on high uptake, effective diagnostic processes and procedures and effective management and treatment

Question 19

bowel cancer sites are common what are the most likely places

Answer 19

rectum - 27%
sigmoid colon - 20%
caecum - 14%

Question 20

what increases risk of bowel cancer

Answer 20

Increase risk radiation , red meat, alcoholic , abdominal fatness, adult-attained height processed meat
60th bday