Health Screening and Health Promotion Review part 1 - LEIK Flashcards
Leading cause of death (all ages/genders):
- Heart disease (or diseases of the heart)
- Cancer (or malignant neoplasms)
- Chronic lower respiratory diseases (i.e., chronic obstructive pulmonary disease
[COPD])
Leading cause of cancer death:
Lung cancer
Leading causes of cancer deaths in men
- Lung cancer
- Prostate cancer
- Colorectal cancer
Leading causes of cancer deaths in women
- Lung cancer
- Breast cancer
- Colorectal cancer
Leading Causes of Death in Adolescents
Death rate for teen males is higher than for females:
1. Accidents/unintentional injuries (39.5%); the most common cause is motor vehicle
crashes (risk is highest from 16 to 19 years of age)
2. Suicide (16.8%): Watch teens for signs of depression, excess stress, and suicidal behavior; open communication between the adolescent and the parents/caregivers (or persons they trust) is extremely important in preventing teenage suicide
3. Homicide (14.3%): Nonfatal and fatal violence are much higher among young people
compared to any other age group.
Leading Cause of Mortality by Age Group
Birth to 12 months
Congenital malformations (20.3%)
Leading Cause of Mortality by Age Group
Ages 1 to 44 years:
• Unintentional injuries
Leading Cause of Mortality by Age Group
Ages 45 to 64 years:
• Cancer (30.9%)
Leading Cause of Mortality by Age Group
Ages 65 and older:
• Heart disease (25.6%)
Life Expectancy
Average life expectancy is 78.6 years
(a decrease of 0.1 year from 2015
Most common cancer:
• Skin cancer (5.4 million)
Most common type of skin cancer:
- Basal cell carcinoma
* Melanoma causes the majority of skin cancer deaths
Most common cancer by gender (prevalence):
• Men
– Prostate cancer
– In men, there are more cases of prostate cancer (prevalence), but the cancer that
causes the most deaths (mortality) is lung cancer
Most common cancer by gender (prevalence):
• Women
– Breast cancer
– In women, there are more cases of breast cancer (prevalence), but the cancer that causes the most deaths (mortality) is lung cancer
Most common cancer among all children:
• Acute lymphoblastic leukemia (ALL; 34% of all cancers in children)
SCREENING TESTS
Sensitivity
A sensitive screening test is very good at identifying/detecting those people who have the disease (true positive).
An easy way to remember is to think of “sensitivity—rule in” or “SSIN or SIN.”
SCREENING TESTS
Specificity
A specific screening test is very good at identifying/detecting those people without the
disease (true negative).
An easy way to remember is to think of “specificity—rule out” or “SPOUT.”
Primary Prevention (Prevention of Disease/Injury)
Individual actions (healthy individuals): Eat a nutritious diet, exercise, use seatbelts and helmets
Primary Prevention (Prevention of Disease/Injury)
Gun safety: Use safety locks for guns; keep guns out of reach of children/teens
Primary Prevention (Prevention of Disease/Injury)
National programs: Federal health-promotion/disease-prevention programs include
immunizations,
the Occupational Safety and Health Administration (OSHA)’s job safety laws, and
Environmental Protection Agency (EPA) laws.
Programs promote a healthy lifestyle for youth (healthy diet, exercise,
Primary Prevention (Prevention of Disease/Injury)
Building a youth center in an urban high-crime area or a Habitat for Humanity (shelter).
Primary Prevention (Prevention of Disease/Injury)
Aspirin prophylaxis for primary prevention of CVD and colon cancer in adults aged 50 to 59 years who have a 10% risk or higher.
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
Screening tests (Pap smears, mammograms, CBC for anemia, etc.)
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
Screening for depression (interviewing a patient about feelings of sadness, hopelessness)
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
Screening for sexually transmitted infections (STIs; asking about sexual history, partners, signs and symptoms)
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
Screening for alcohol abuse (interviewing a patient using the CAGE questionnaire)
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
Testing for hepatitis C virus infection in a person with risk factors
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
Having a person with a history of MI, TIA, or stroke take an aspirin or statin daily (to prevent a future stroke or MI)
Tertiary Prevention (Prevention of Disease Progression, Rehabilitation, Support Groups, Education on Equipment)
Support groups: Alcoholics Anonymous (AA), breast cancer support groups, HIV support groups
Tertiary Prevention (Prevention of Disease Progression, Rehabilitation, Support Groups, Education on Equipment)
Education for patients with preexisting disease (i.e., diabetes, hypertension): Avoidance of drug interactions, proper use of wheelchair or medical equipment, others
Tertiary Prevention (Prevention of Disease Progression, Rehabilitation, Support Groups, Education on Equipment)
Rehabilitation: Cardiac rehabilitation, physical therapy (PT), occupational therapy (OT)
Tertiary Prevention (Prevention of Disease Progression, Rehabilitation, Support Groups, Education on Equipment)
Treatment of a person with hepatitis C virus infection
Tertiary Prevention (Prevention of Disease Progression, Rehabilitation, Support Groups, Education on Equipment)
Treatment of a person who has already had a heart attack with daily aspirin (to prevent
another heart attack)
Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer (April 2016)
Age 50 to 59 years with equal or more than 10% risk (10-year cardiovascular disease risk) Initiate
Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer (April 2016)
Initiate low-dose aspirin use for primary prevention of cardiovascular and colorectal cancer (in patients who are not at increased risk for bleeding) with life expectancy of at least 10 years and who are willing to take low-dose aspirin daily for at least 10 years)
Breast Cancer (January 2016)
Baseline mammogram: Start at age 40 years and repeat every 1 year 40-55, then every 2 years until the age of 74
years
Breast Cancer (January 2016)
Age 75 years or older: Insufficient evidence for routine mammogram
Breast Cancer (January 2016)
Does not apply to women with known genetic mutations (BRCA1 or BRCA2), familial
breast cancer, history chest radiation at a young age or previously diagnosed with highrisk
breast lesion who may benefit from starting screening in their 40s
Cervical Cancer Screening
Age 25 years or younger
Do not screen (even if sexually active with multiple partners). Cervical cancer is rare before age 21 years
Cervical Cancer Screening
Age 25 to 65 years
Baseline at age 25 years. Screen every 3 years (pap) or Primary HPV test every 5 years, or Co-test (HPV w/Pap) every 5 years.
Cervical Cancer Screening
Age 25 to 65 years
Another option starting at age 30 years is to screen with combination of cytology plus human papillomavirus (HPV) testing every 5 years.
Cervical Cancer Screening
Had hysterectomy with removal of cervix
If hysterectomy with cervical removal was not due to cervical intraepithelial neoplasia (CIN grade 2) or cervical cancer, then can stop screening.
Cervical Cancer Screening
Women older than 65 years who had
adequate prior screening
Do not screen if history of adequate prior screening and is otherwise not at high risk for cervical cancer.
regular cervical cx testing last 10
years + normal results: no more screenings
Hx of serious pre-cancer: test at least 25
years after diagnosis (even past age 65)
Cervical Cancer Screening
These recommendations do not apply to women who are immunocompromised (i.e., HIV infection), had in utero exposure to diethylstilbestrol (DES), or have a diagnosis of high-grade precancerous cervical lesion or cervical cancer.
Colorectal Cancer (June 2016)
Baseline: Starting at age 45 years until the age of 75 (older age is the most common risk factor)
Colorectal Cancer (June 2016)
Age 76 to 85 years: Against routine screening but “there may be considerations”; individualize screening as needed - risk factor discussion
Colorectal Cancer (June 2016)
Older than age 85 years: Screening for colorectal cancer not recommended
Colorectal Cancer (June 2016) These three methods are all acceptable for colorectal cancer. The screening intervals of each method differ:
High-sensitivity fecal occult blood test (gFOBT)
High-sensitivity fecal occult blood test (gFOBT) annually (high-sensitivity version such as Hemoccult SENSA superior to older Hemoccult II test)
Colorectal Cancer (June 2016) These three methods are all acceptable for colorectal cancer. The screening intervals of each method differ:
CT or flexible sigmoidoscopy
Flexible sigmoidoscopy or CT colonography every 5 years
Colorectal Cancer (June 2016) These three methods are all acceptable for colorectal cancer. The screening intervals of each method differ:
colonoscopy
colonoscopy every 10 years
