Screening Guidelines Flashcards
What are the options of screening for colon cancer and how frequently?
1) colonoscopy (if normal, every 10 years)
2) FIT testing annually (if positive, must do colonoscopy)
3) flexible sigmoidoscopy (q5 years, AND FIT every 3 years)
4) CT colonography q5 years
At what age should you start screening for colon cancer?
In normal adults, 50.
If patient has a 1st degree relative w/ CRC or advanced adenocarcinoma BEFORE age 60…or if they have had 2 relatives with CRC or advanced adenocarcinoma at ANY age…then start at 40 or before the youngest case
Who is considered high risk for colon cancer? When should they start being screened? How frequently?
1) A relative w/ CRC or advanced adenoCA BEFORE age 60 or 2 relatives of any age. Start at age 40 or 10 years before the youngest case. Screen every 5 years (if nl tests)
2) FAP –> screen with flex sig or colonoscopy EVERY year until colectomy (if any rectum is retained, as in subtotal colectomy, continue flex sigmoidoscopy q6-12 months)
3) HNPCC (Lynch syndrome) –> colonoscopy q2 years from ages 20-25 to 40, then annually after 40
Even if a patient has a 1st degree relative w/ CRC or advanced adenoCA, as long as that relative was over age __ years old at diagnosis, then the normal colon cancer screening guidelines apply.
age >60
If hyperplastic polyps are found on colonoscopy, when should the next one be performed?
10 years
What findings on colonoscopy indicate that the next colonoscopy should be performed in 5-10 years?
1) 2 or less tubular adenomas; AND
2)
What findings on colonoscopy indicate that the next colonoscopy should be performed in 3 years?
1) 3 or more tubular adenomas; OR
2) >1 cm lesions; OR
3) villous adenoma; OR
4) high-grade dysplasia
Who should be screened with low dose CT for lung cancer?
patients between 55-80y with over 30 pack year smoking history who are either:
1) current smokers; or
2) quit within the past 15 years
You can have an individualized discussion with men between the ages of __ and __ about PSA screening (rectal exams no longer recommended)
between 55-69.
Not recommended after age 70
When should women start having mammographies? How often? When is it no longer recommended?
start screening at 50. Screen every 2 years. After age 75, it is no longer recommended
What are the cervical cancer screening guidelines?
1) From 21-29, Pap q3 years
2) From 30-65, can keep Pap q3 OR can do Papq5 with HPV testing
3) If 65+, can stop screening if:
1) patient has had 3 consecutive negative Paps in past 10 years; or
2) 2 consecutive Pap+HPV negative in past 10 years
NOTE: screening should continue at least 20 years after the management of a precancerous high grade lesion, even if the patient is over 65!!
Who should be screened for osteoporosis?
Women >65, or women aged 50-64 if they have a risk factor (FRAX >/= that of a 65 year old, 9.3% chance of fracture)
What are the screening guidelines for aortic aneurysms? What do you do depending on the results?
In MEN who have EVER smoked between age 65-75
If aorta is:
1) 4.5, refer to vascular surgery
What are the screening guidelines for blood pressure?
1) start at age 18
2) every 2 years if SBP 120 and DVP >80
What are the screening guidelines for HLD?
q5 years starting at age 20 if have risk factor (DM, HTN, obesity, smoking, family history of HLD)
or q5 starting at 35 (in men) and 45 (in women)
