oncology

Question 1

when does AAA screening get offered

what would a 3.5cm need
what would a 5cm need
what is cut off for referral

Answer 1

65 years
< 3 cm Normal - No further action

3 - 4.4 cm Small aneurysm Rescan every 12 months

4.5 - 5.4 cm Medium aneurysm Rescan every 3 months

> = 5.5cm Large aneurysm Refer within 2 weeks to vascular surgery for probable intervention
Only found in 1 per 1,000 screened patients

Question 2

when is breast ca screening offered

Answer 2

3 yearly form 47 years

Question 3

what risk factors would indicate breast referral in history of only one 1st degree

Answer 3

If the person concerned only has one first-degree or second-degree relative diagnosed with breast cancer they do NOT need to be referred unless any of the following are present in the family history:
age of diagnosis < 40 years
bilateral breast cancer
male breast cancer
ovarian cancer
Jewish ancestry
sarcoma in a relative younger than age 45 years
glioma or childhood adrenal cortical carcinomas
complicated patterns of multiple cancers at a young age
paternal history of breast cancer (two or more relatives on the father’s side of the family)

Question 4

what are the most common cancers in female

Answer 4

The 3 most common types of cancer in females are:
1. Breast (prostate male)
2. Lung
3. Bowel

Question 5

what are the commonest cancers to cause death

Answer 5

The most common causes of death from cancer in the UK are as follows:
1. Lung
2. Colorectal
3. Breast

Question 6

tumour markers
CA 125 (AFP + bhcg)
CA 19-9
CA 15-3

Answer 6

Ovarian cancer (germ cell tumours)
Pancreatic cancer
Breast cancer

Question 7

genes related to breast ca

Answer 7

BRAC1/2
TP53

Question 8

when is cervical screening offered

Answer 8

A smear test is offered to all women between the ages of 25-64 years
25-49 years: 3-yearly screening
50-64 years: 5-yearly screening
cervical screening cannot be offered to women over 64

delyaed 3months postportum

Question 9

smear test is positive for HPV, what occurs next

Answer 9

Positive hrHPV
samples are examined cytologically
if the cytology is abnormal → colposcop
if normal - repeat in 1 year

Question 10

risk factors for ovarian ca

Answer 10

Nulliparity.
Postmenopausal status (75% of cases are diagnosed in women over 55y).
Personal history of breast cancer.
Family history of breast or ovarian cancer.
Small increased risk with HRT.
Genetics, particularly BRCA genes and Lynch syndrome.

Question 11

management of a ovarian cyst of >7cm

(post-menopasual = refer)

Answer 11

check ca 125 + refer yrgent to gyane
5-7cm = reassure, annual follow up
<5 cm = no action needed