USPSTF Cancer Screening Guidelines Flashcards
The grade recommendation for colorectal cancer screening is grade A for what age group? Grade C for what age group?
A = 50-75
C = 75-85
What are the three stool-based screening methods for colorectal cancer?
buiac based recal occult blood (FOBT)
Fecal immunochemical testing
Fecal immunochemical testing with DNA
What are the three direct visualization screening methods for CRC?
colonoscopy
flex sig
CT colonography
How often should you be tested if you use the FOBT method?
annually
What is the pooled estimate of CRC mortality reduction in the FOBT trials? Any reduction in all cause mortality?
15% reduction in CRC mortality
but no reduction in all-cause mortality
What is the reduction in CRC mortality for flex sig?
27%
What is the risk reduction in CRC mortality for colonoscopy?
trick question - we don’t know because there haven’t been any RTCs
How do the FIT and FIT-DNA studies compare in terms of sensitivity and specificity?
FIT-DNA has higher sensitivity (92% vs 88% for FIT), but lower specificity (84% vs. 93%) so will have more false positives
What are the risks of colonoscpy?
4 colonic perforations and 8 major intestinal bleeding per 10,000 screening colonoscopies
(note: 85% of serious complications are associated with polypectomies)
What is the main harm of screening with CT colonography?
extra-colonic findings are common (40-70% of screens), so there are potential risks to the diagnostic follow-up
What is the recommendation grade for breast cancer screening in ages 50-75?
Ages 40-49?
Grade B for 50-75
Grade C for 40-49
What is the recommended frequency of mammography?
every 2 years
True or false: mammography has been found to significantly decrease breast cancer mortality and all-cause mortality.
False - significantly reduces the risk for breast cancer in women ages 50-69, but no changes in all-cause mortality
What is the sensitivity of mammography?
77 to 95%
What is the specificity of mammography?
94 to 97%
In ages 50-75, how many many breast cancer deaths were prevented for 1000 screened?
only 7
122 life-years gained
According to the USPSTF, who should be screened for lung cancer?
Current or past smokers within 15 years with a 30-pack/yr hx, starting at age 55 through age 80
What is the recommendation grade for lung cancer screening in this population?
grade B
What is the screening test for lung cancer?
annual low dose CT
In a study comparing low dose CT to CXR, what was the reduction in lung cancer mortality? in all-cause mortality?
20% reduction in lung Ca mortality
6.7% reduction of all-cause mortality
What is the sensitivity of low dose CT?
~90%
What is the specificity of low dose CT?
broader range: 28-100% depending on study
What is the PPV of low dose CT?
2-42%
What is the radiation exposure with a low dose CT scan and how does it compare to the background radiation?
0.5-1.61 mSV for the low dose CT scan
background radiation exposure is about 2.4 mSV/yr in the US
