W07_05 Cancer Prevention, Screening, Diagnosis

Question 1

what are two major components of early cancer detection?

Answer 1

education;

screening

Question 2

education of risk, lifestyle, etc. is which type of prevention (primary, secondary, tertiary)?

Answer 2

primary

Question 3

immunization is which type of prevention (primary, secondary, tertiary)?

Answer 3

primary

Question 4

screening programming is which type of prevention (primary, secondary, tertiary)?

Answer 4

secondary

Question 5

treatment and support is which type of prevention (primary, secondary, tertiary)?

Answer 5

tertiary

Question 6

name some organs involved in cancer from smoking

Answer 6

lung, oral cavity, larynx, esophagus, bladder, kidney, pancreas, stomach, cervix

Question 7

why does obesity lead to increased risk of breast and endometrial cancers?

Answer 7

both are related to high estrogen. adipose tissue contains aromatases that convert androgens to estrogen

Question 8

what kind of diet can help prevent colon cancer?

Answer 8

high fibre, low red meat

Question 9

note: smoked/salted/nitrite-preserved foods may contribute to stomach cancer

Answer 9

ok

Question 10

what are some mechanisms of alcohol-caused carcinogenesis

Answer 10

acetaldehyde intermediate;
ROS;
impaired absorption of other compounds;
increased estrogen

Question 11

surgical prophylaxis is offered for which hereditary cancer syndrome organs?

Answer 11

breast and ovary (brca1/2);
colon (FAP, HNPCC);
stomach (CDH1);
thyroid (ret - MEN2);
testis (cryptorchidism)

Question 12

note: you can screen for cancers of the cervix, breast, colon

Answer 12

ok

Question 13

note: get tumours before they’ve penetrated the basement membrane

Answer 13

ok

Question 14

define carcinoma in situ

Answer 14

severe dysplasia that’s involving the entire thickness of the epithelium, with no BM penetration

Question 15

how to best diagnose ductal carcinoma in situ of the breast?

Answer 15

mammography (80% is non-palpable!)

Question 16

what does cancer care ontario recommend for breast cancer screening?

Answer 16

every two years for those >50yo.

every year for high risk women >30yo.

Question 17

what are the pre-invasive lesions in the colon?

Answer 17

adenomatous polyps

Question 18

what are the major types of adenomas in the colon?

Answer 18

villous adenomas, tubular adenomas, tubulovillous adenomas

Question 19

name a few methods for colon cancer screening

Answer 19

fecal occult blood test;
sigmoidoscopy;
colonoscopy;
virtual colonoscopy;
air contrast barium enema

Question 20

what does cancer care ontario recommend for colorectal cancer screening?

Answer 20

FOBT every 2 years >50;

if high risk, colonoscopy for 50 or 10 years before onset in first relative;

Question 21

what are we screening for the cervical cancer screen?

Answer 21

squamous intraepithelial lesion (SIL) / cervical intraepithelial neoplasia (CIN)

Question 22

how are LSIL and HSIL different?

Answer 22

LSIL (HPV 6,11) usually regresses, but some will progress into HSIL (HPV 16,18). most of HSIL will persist

Question 23

what’s a koilocyte?

Answer 23

squamous epithelial cell that’s undergone a series of structural changes as a result of HPV infection

Question 24

what does LSIL look like under the microscope?

Answer 24

koilocytes - large nucleus with perinuclear halo, hyperchromasia

Question 25

what does HSIL look like under the microscope?

Answer 25

high nucleus:cytoplasm ratio

Question 26

what does cancer care ontario recommend for cervical cancer screening?

Answer 26

start for women 21+ and pap smear every 3 years;
if HSIL - colposcopy+biopsy;
if LSIL - repeat pap in 6 months or colposcopy

Question 27

what prostate cancer screening methods exist?

Answer 27

digital rectal exam;
ultrasound;
prostate specific antigen