Gi Screening/Epidemiology - Westra

Question 1

At what age should screening for CRC begin in an adult with average risk?
What screenings? How often?

Answer 1

After 50yo (until 75yo)

Colonoscopy - every 10 yrs without abnormal result
or
Flex Sigmoidoscopy - every 5 yrs
or
FOBT - yearly

(risks/benefits vary between screening methods)

Question 2

Why is it important to remove polyps during colonoscopy screening?

Answer 2

95% of CRC arises from adenomatos and serrated polyps

usually take about 10 years

Question 3

How does your beginning screening age change if you are black?

Answer 3

Should then begin at 45yo

Question 4

Which part of the esophagus is involved in squamous cell carcinoma vs adenocarcinoma?

Answer 4

Squamous Cell = upper and middle third of esophagus

Adenocarcinoma = lower third (barret’s)

Question 5

Big RISK FACTORS for squamous cell carcinoma vs adenocarcinoma?

Answer 5

Squamous Cell = tobacco, alcohol, mucosal irritants, carcinogens, poor diet

Adenocarcinoma = GERD, barret’s, obesity, diet

Question 6

Why is hepatocellular carcinoma so much more common in China and Western Africa as compared to Northern Europe and the Americas?

Answer 6

Hepatitis B is much more common in Asia and Africa.

Aflotoxins are fungal toxins produced by Aspergillus fungus species growing on nuts

Question 7

Why might you check hemoglobin levels for a patient you suspect has hepatocellular carcinoma?

Answer 7

Check Hb because hemochromatosis is one of the causes of hepatocellular carcinoma