Prevention And Early Detection Of Cancer Flashcards
It is a strong modifiable risk factor for cardiovascular dx, pulmonary dx, and cancer
Tobacco smoking
Those who stop smoking have _____ lower 10 yr lung CA mortality rate
30-50%
Smoker who is quitting goes through identifiable stages including:
Contemplation of quitting
Action phase
Maintenance phase
What type of smokers Commit PROGRAM is not successful
Heavy smokers >25 cigarettes per day
It is a program in which light smokers are successful in quitting
Community intervention trial for smoking cessation (COMMIT)
What cancer that has higher risk when one to 2 cigars were smoked
Doubles the risk for esophageal and oral CA
3 or 4 cigars has increase risk for what
Eight fold for oral CA and four fold for esophageal CA
Physical act is associated with a dec risk of
Colon and breast CA
Diets high in fat is associated with increased risk for?
PE BC
Prostate
Endometrium
Breast
Colon
Risk of certain cancers appear to increase MODESTLY when BMI is what?
25 kg/m
5 kg/m2 BMI is associated with what?
Uterus, kidney, cervix, thyroid, leukemia gallbladder,
Exposure to UV radiation can cause
Nonmelanoma skin CA
Risk factors for melanoma
- sunburn
- benign melanocytic nevi
- atypical nevi
Initial changes in cancer
Initiation
Progress through carcinogenic process and change phenotypically are called?
Promoters
Promoters include what?
Androgen - linked to prostate CA
Estrogen - breast and endometrial CA
Smoking causes epithelial origin to where?
Esophagus, lungs,oral and neck
Hpv 16 causes
Oropharynx cancer
Premalignant lesion found in smokers and used as an intermediate marker of chemopreventive activity
Oral leukoplakia
It causes regression to oral leukoplakia
Isotretinoin
Most colorectal CA develops from
Adenomatous polyps
May prevent adenoma formation or regression of adenomatous polyps
NSAIDS [aspirin 75 mg/d, sulindac and piroxican]
COX -2 as chemoprevention in colorectal is not considered due to what side effect
Cardiovascular events
What dietary element reduces the colorectal CA
Calcium
Estrogen plus progestin therapy in colorectal CA can cause what?
Cadiovascular and breast CA
Antiestrogen with partial estrogen agonistic activity in endometrium and bone and it upregulate transforming growth factor beta that dec breast proliferation.
Tamoxifen
Side effects of tamoxifen?
Bone fracture Small inc risk of endometrial ca Stroke Pulmonary emboli DVT
It is comparable with tamoxifen and it has no inc risk for endometrial CA
Raloxifene
It is effective than tamoxifen
Aromatase inhibitors
Common side effects of AI
HAFI Hot flashes Arthralgias Fatigue Insomnia
What are the 5 alpha reductase inhibitors that is used as chemoprevention for prostate CA that inhibit conversion of testosterone to dihydrotestosterone
FINASTERIDE AND DUTASTERIDE
What cancer is linked to Hepatitis B and Hepatitis c virus
Liver CA
HPV are linked to what cancers?
CHAN Cervical Head Anal Neck CA
H. Pylori is associated with?
Gastric adenocarcinoma and gastric lymphoma
What vaccine that is effective in preventing hepatitis and hepatomas
Hepatitis B vaccine
What HPV types that causes genital papillomas
HPV types 6 and types 11
At what age does 2 dose of HPV vaccine is recommended?
9-14 yrs
Age ate 3 doses of HPV is recommended
15 - 26 yrs
It is used to prevent colon CA
Colectomy
Surgery for breast CA
Mastectomy
Surgery for preventing ovarian and breast CA in high isk?
Salpingo-oophorectomy
It is important for early detection in asymptomatic individuals with the goal of decreasing morbidity and mortality
Screening
True positive rate, or when a persons with a dx who test positive in the screen
Sensitivity
False positive rate, it is when the dx is not present
Specificity
Proportion of persons who do not have the disease that test negative in the screening test
Negative predictive value
Who test positive and actually have the dx
Positive predictive value
The remaining HPV types causes what?
Cervical and anal CA
Whether or not a test influences the natural hx of disease
Lead time bias
Screening tests that generally easily detect slow growing and less aggressive CA
Length time sampling
Extreme length biased sampling
Overdiagnosis
It is when population most likely to seek screening often differs from the general population to which screening test might be applied.
Selection bias
How often do you screen with mammography 45-54 yrs
Annual
Biennial screening is recommended at what age
More than or equal 55 yrs old.
Self examination what age?
Women, all ages
At what age Pap test is recommended?
21-65 yrs with interval of 3 yrs
Women age 65 with no abnormal results in the previous 10 yrs may choose to stop screening.
T or F
True
At the beginning of age 30, with a guidelines offer the alternative of combined Pap smear and HPV what interval screening in this approach
5 yr interval
<30 years does not use HPV testing T or F?
T
Women after total hysterectomy for noncancerous cause is not recommended for screening T or F
T
What is the diagnostic test for colorectal CA
Sigmoidoscopy at age 50-75 every 5 yrs
Fecal occult blood testing how often for screening?
Annually
Interval for colonoscopy
Every 10 yrs starting at age 50 and above
FIT is done every?
Annually
Fecal DNA testing is done every
1 or 3 yrs
CT colonography is done every
5 yrs
What is the diagnostic testing for lung CA
Low dose CT scan
Low dose CT scan is recommended at Age 55- 80 with a > or equal 30 pack yr smoking history or stil smoking or have quit within past 5 yrs
T or F
T
Is CA 125 and transvaginal US recommended at all ages?
T or F
F, it is not recommended at all ages
Recommended only when woman have high risk for ovarian CA with perisistent symptoms.
Most common screening for prostate CA
Digital rectal exam and serum PSA assay
What examination is used in skin cancer
Visual examination
