Screening and Prevention Flashcards

1
Q

What are the levels of prevention?

A

1st - wellness activities focused on patients with risk factors but without disease (e.g., use of condoms by MSM)
2nd - screening of patients with pre-clinical stages of disease (e.g., screening IDUs for HIV infection)
3rd - prevention of complications for patients with active disease (e.g., use of antiretroviral medications to prevent OIs in PLHIV)

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2
Q

When is screening recommended in older adults?

A

when balance of life expectancy, functional status, comorbid conditions, overall health goals, preferences, and benefits of screening test outweigh risks

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3
Q

What are the USPSTF recommendations regarding breast cancer screening in women?

A

women ages:

  • 40-49 should have a discussion with provider and decision should be individualized (shared decision making)
  • 50-74 every 2 years
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4
Q

What are the American Cancer Society recommendations on breast cancer screening in women?

A

start screening at age 45
- 40-44 should have the opportunity to begin annual screening (shared decision making)
- 45 to 54 annual screening
- 55 and older may be screened bi-annually
=> screening for women older than 50 is not controversial - the benefit of screening increases with age

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5
Q

What is the recommended screening test for breast cancer?

A

mammography - CT, MRI, and ultrasound do not have a clear place

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6
Q

What are the recommendations on self breast exam (SBE)?

A
  • USPSTF: recommends against

- American Cancer Society: recommends breast awareness (aware of normal appearance and changes) => SBE optional

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7
Q

What are the recommendations on clinical breast exam (CBE)?

A
  • USPSTF - no recommendation

- American Cancer Society - does not recommend CBE as a screening method

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8
Q

What is the USPSTF recommendation on prostate screening?

A

USPSTF recommends AGAINST routine PSA-based screening for men of average risk, regardless of age

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9
Q

What is the American Cancer Society recommendation on prostate screening?

A

shared decision making for men 50 to 70 - start at age 45 for African American men

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10
Q

What is the recommended screening test for prostate cancer?

A

prostate specific antigen (PSA) for patents who prefer to be screened - digital rectal exam (DRE) can improve cancer detection but only for cancers at advanced stages (has no effect on cancer mortality)

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11
Q

What are the recommendations for colon cancer screening?

A

both USPSTF and ACS recommend screening between ages 50 and 75 for patients at average risk

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12
Q

What is the recommended screening test for colon cancer?

A

any of the following can be used - none of the methods has proven superior:

  • colonoscopy (direct visualization) q 10 years
  • flexible sigmoidoscopy (direct visualization - limited to the rectum and sigmoid) q 5 years
  • CT colonography (virtual colonoscopy) - q 5 years
  • fecal occult blood (detection of “heme” portion of hemoglobin) q 1 year
  • fecal immunochemical testing (detection of “globin” portion of hemoglobin) q 1 year
  • stool DNA (detects DNA of cancer cells shed in stool) q 1 year
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