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PP > Lecture 18 - Neoplasia 6 > Flashcards

Lecture 18 - Neoplasia 6 Flashcards

1
Q

What is cancer screening?

A

When cancers with a significant burden are screened for

Attempts to detect cancers as early as possible

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2
Q

What are the benefits of cancer screening?

A

-Detect problem early before patient has any symptoms
-Treatment more effective if the problem is detected early
-reduce number of deaths from screened diseases
-can help individuals make better informed decisions about their health

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3
Q

What are the risks/limitations of cancer screening?

A

-False positives + false negatives
-some results can lead to difficult decisions
-anxiety associated with knowledge of a health problem
-person could get a -ve but later go onto develop condition

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4
Q

What is a normal (screen negative) screening result?

A

Low risk of having the condition you were screened for

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5
Q

What is a high risk (screen positive) screening result?

A

May have condition you’ve been tested
Further tests give to confirm this

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6
Q

What is a false positive screening result?

A

Someone with a. Positive screening result who does not have the target condition

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7
Q

What is a false negative screening result?

A

Someone with a negative screening result who DOES have the target condition

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8
Q

What is sensitivity for a screening programme?

What does it mean if a test is highly sensitive?

A

Ability of the screening test to identify people with the conditions as positive

Highly sensitive = few false negatives

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9
Q

What is specificity for a screening programme?

What does it mean if a test is highly specific?

A

Ability of the screening programme to identify healthy people as negative

Highly specific test = few false positives

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10
Q

What are the 3 most common screening programmes?

A

Breast cancer
Cervical cancer
Colorectal cancer

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11
Q

Who are normally screened for Abdominal Aortic Aneurysm?

A

Men over 65yrs

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12
Q

How frequently do women between the ages of 47-73 yrs receive mammograms?

A

Every 3yrs

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13
Q

How frequently are women between ages 25-49 screened for cervical cancer?

A

Every 3 years

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14
Q

How frequently are women aged 50-64yrs old screened for cervical cancer?

A

Every 5 years

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15
Q

What are home test kits for bowel cancer screening looking for in men and women between 60-74?

A

Blood in faeces

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16
Q

What is being screened for in babies between 10-12 weeks old?
What causes these diseases?

A

Down’s syndrome (Trisomy Chromosome 21)
Pataus syndrome (Trisomy Chromosome 13)
Edward syndrome (Trisomy Chromosome 18)

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17
Q

Why is diabetic eye screening done especially in pregnancy?

A

Blood sugar control is really varied in pregnancy

18
Q

What are the screening programmes for new born babies?

A

Physical exams
Hearing exam
Blood spot/heel prick test

19
Q

What are the 5 conditions that are screen for in the heelprick/bloodspot test?

A

Sickle cell disease
Cystic fibrosis
Congenital Hypothyroidism
6 Inherited metabolic diseases
Severe Combined Immunodeficiency (SCID)

20
Q

What are the 6 inherited metabolic diseases screened for in the heel prick test?

A

Phenylketonuria (PKU)
MCADD
Homocystinuria (HCU)
Maple syrup urine disease (MSUD)
Isovaleric acidaemia (IVA)
Glutaric aciduria type 1 (GA1)

21
Q

What is being tested for in the smear test for the Cervical Cancer Screening Programme?

A

High risk (HPV) Human Papilloma Virus in the cells

22
Q

When are the cervical cells assessed under the microscope in the Cervical Screening Programme (smear test)?

A

When HPV positive

23
Q

How is a cervical smear test done?

A

Speculum opens the walls of the vagina
A little brush brushes the cervix to collect some cells
Cells then tested for HPV

24
Q

What is dyskaryosis?

A

Dysplasia (an interchangeable term)

When the cervical screening test is +ve for HPV and cells have abnormal changes

25
Q

If a smear test is HPV +ve why is important to check the cells under a microscope?

A

Checking for dysplasia/degree of dysplasia

26
Q

What are some changes that occur in dysplasia?

A

Increased nuclear size
Cells become darker
Irregular size and shape

27
Q

When does dysplasia become invasive cancer?

A

When the cells invade the basement membrane

28
Q

How may self sampling help in the cervical screening programme?

A

May encourage non -attenders to take part

29
Q

How May extending recall intervals affect cervical screening?

A

hrHPV testing has a high negative predictive value

By extending the screening interval to 5yrs for all women helps reduce burden on NHS

30
Q

Who are screened for Abdominal Aortic Aneurysms?

A

Men over 65yrs old

31
Q

What is considered an abdominal aortic aneurysm?

A

Aorta diameter over 3cm wide

32
Q

What are the 3 types of aneurysm?

A

Fusiform
Saccular
Mycotic

33
Q

What is a Fusiform aneurysm?

A

Aneurysm bulges out on ALL sides of the blood vessel

34
Q

What is a saccular aneurysm?

A

Aneurysm bulges out only on the one side

35
Q

What is a mycotic aneurysm?

A

Aneurysm caused by bacterial infection of the arterial wall

36
Q

How are people with abdominal aortic aneurysms managed?

A

3 - 4.4cms (yearly surveillance)
4.5 - 5.4cms (3 monthly surveillance

5.5cms > referral to cardiovascular surgeon

37
Q

How are abdominal aortic aneurysms usually operated on?

A

Stent graft inserted
This creates a new tube in the aorta preventing the blood flowing to the weakened areas/walls

38
Q

How can we measure the performance of a screening programme?

A

Incidence
Reduction in mortality
Interval cancers (if -ve doesnt mean your not going to develop cancer later)

39
Q

What is lead time bias?

A

When a disease is detected by a screening or surveillance test at an earlier time point than it would have been if it had been diagnosed by its clinical appearance
May have been asymptomatic for a while

Therefore it appears that the patient survives longer with the disease

40
Q

Why is over diagnosis n issue with screening programmes?

A

A disease which is insitu and may have remained in situ would be surgically removed as a precaution (it may have never actually developed into cancer)

PP (20 decks)

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