Screening programmes

Question 1

UK breast cancer screening ages

Answer 1

Women aged 50-70, every 3 years. Mammogram.

Question 2

When would you refer to breast screening if there is a family history in ONE first or second degree relative

Answer 2

If any of these are present in fhx:
- Under 40 @ age of diagnosis
- Bilateral breast cancer
- Male breast cancer
- Ovarian cancer
- Jewish ancestry
- sarcoma in a relative under 45
- 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 3

When is bowel ca screening routinely offered and how often?

Answer 3

Age 60-74
Every 2 years

Question 4

When to refer for 2ww colonoscopy

Answer 4

• Patients >= 40 years with unexplained weight loss AND abdominal pain
• Patients >= 50 years with unexplained rectal bleeding
• Patients >= 60 years with iron deficiency anaemia OR change in bowel habit
• Tests show occult blood in their faeces (see below)

Question 5

When would you refer someone for their prostate?

Answer 5

Men aged 50-69 years should be referred if the PSA is >= 3.0

Abnormal DRE

Question 6

Other reasons PSA may be elevated, and how long to wait in each circumstance to test?

Answer 6

• BPH
• UTI/ prostatitis. Wait a month after treating to test.
• Ejaculation & Vigorous exercise: wait 48 hours to test
• Urinary retention
• Instrumentation of the urinary tract

Question 7

When would you use tamoxifen/anastrazole

Answer 7

PRE menopausal ER +ve breast ca = tamoxifen (selective oestrogen receptor modulator)

POST menopausal ER+ve breast ca = anastrozole. (aromatase inhibitor)