Screening Flashcards
Breast Cancer
40-49: Not recommended
50-74: Routine q2-3yrs
75+: Screen if benefits outweigh harm
Lung Cancer
Annual screening with low dose CT for adults aged 55-74 with at least 30 pack year smoking hx who currently smoke or quit less than 15 yrs ago, up to 3 consecutive times
Colorectal Cancer - average risk
> /= 50yo
FOBT q2yo OR flexible sigmoidoscopy q10y
No colonoscopy as a screening test
No screening after age 75 for average risk pts
Colorectal Cancer - first degree relative with cancer or adenomatous polyp at age <60 OR two or more 1st degree relatives with polyp or colon cancer at any age
Colonoscopy every 5 years
Start at age 40 or 10 yr younger than earliest case in family
Colorectal cancer - first degree relative with cancer or adenomatous polyp at age >60 or 2 or more 2nd-degree relatives with polyps of colon cancer
Average risk screening
Start at age 40
Colorectal cancer - one second degree or third degree relative affected
Average risk screening
Start at age 50
Cervical cancer
All women >/= 25yo q3y
If >/= 70yo, 3 normal tests in a row and no abnormal tests in last 10 yrs can discontinue screening
Cervical cancer - pregnant women, women who have sex with women
Routine screening
Cervical cancer - complete hysterectomy
Discontinue screening if for benign disease, swab vaginal vault if hx of malignancy/dysplasia
Cervical cancer - subtotal hysterectomy
Continue screening
Prostate cancer
Screening for prostate CA with PSA is NOT recommended
BRCA 1
- 65% for breast CA
* 40% for ovarian CA by age 70
BRCA 2
- 45% for breast CA
* 10% for ovarian CA
Vaccination for shingles
50+ yo with Shingrix (recombinant zoster vaccine)
preferred to 60+ yo with Zostavax (live zoster vaccine)
Colorectal cancer screening for IBD
Involves majority of colon for over 8 yrs or left colon for over 15 yrs –> colonoscopy q1-2 yrs with biopsies
Screening for aortic aneurysms
Smoking men >60-75yo should have an U/S
If risk of HTN, Marfan’s, Ehlers-Danlos syndrome or an affected first degree relative, screening should start earlier or at age 60
Screen men age 45-50 with PSA if…
FHx of prostate CA in 1st or 2nd deg relative
African American
PSA screening for men age 50-70 with >10yr life expectancy result/course of action
Shared decision
PSA >3 –> more frequent PSA and possible biopsy
PSA 1-3 –> Repeat q2yr
PSA <1 –> Repeat q4yr or if theyre 6yo, don’t screen
PSA screening for men age 50-70 with <10yr life expectancy
Don’t screen
Pts who still require pap smear even after hysterectomy are:
Those who had partial hysterectomy
Those who had hysterectomy for tx of cancer
Those whose previous cervical cancer screening revealed CIN2, CIN3 or worse
Those who never had pap test done
F/O after total hysterectomy for fibroids in pt with history of HSIL in previous pap
HPV DNA testing at least once and vaginal colposcopy q6mo x 2yr
When to screen lipids
Men >/40
Women >/=50
All pts with pre-existing risk related conditions (ie. HTN, DM, CKD)
All pts with known fam hx of premature CVD (men <55 and women <65 in first degree relative)
Rescreen q1-5yrs depending on results
