Week 9: cancer screening

Question 1

What cancers are there screening programmes for

Answer 1

1. Breast
2. Colorectal
3. Cervical

Question 2

Describe breast cancer screening

• what age
• frequency
• what type of investigation

Answer 2

Ages 50-70yo

Mammogram every 3 years

Question 3

Describe colorectal cancer screening

• what age
• frequency
• what type of investigation

Answer 3

Age >50yo

Faecal occult blood annually

(Pilot screening programme) Sigmoidoscopy every 5 years

Question 4

Describe cervical cancer screening

• what age
• frequency
• what type of investigation

Answer 4

Age 25-64yo

25-49: every 3 years
50-64: every 5 years
>65: only if recently had abnormal test

Cervical smear

Question 5

Describe colorectal cancer screening in members of families with FAP

• what age
• frequency
• what type of investigation

Answer 5

From age 12-15

Every year

Colonoscopy

Question 6

Describe colorectal cancer screening in members of families with HNPCC

• what age
• frequency
• what type of investigation

Answer 6

From age 25 or 5 years earlier than youngest relative diagnosed (whichever comes first)

Every 1-2 years

Colonoscopy

Question 7

What is being looked for in a mammogram during screening

Answer 7

Microcalcification

Question 8

If a cervical smear comes back suspicious, what should be done?

Answer 8

If CIN2/3

1. colposcopy + biopsy
2. cone biopsy to remove transition zone (if step 1 wasnt done completely)

Question 9

Which type of cervical cancer is screening useful for

Answer 9

Squamous cell cancer

not so reliable in detecting adenocarcinoma

Question 10

WHO has 10 principles of screening.

List
3 criteria related to the condition being screened for

Answer 10

1. Condition is impt helth problem
2. Condition has a recognisable early stage
3. Condition is adequately understood (from latent stage to development of declared disease)

Question 11

WHO has 10 principles of screening.

List
3 criteria related to the policies/ healthcare professionals doing the screening

Answer 11

1. Agreement on who to treat as patients
2. Agreement on how to treat pts with recognised disease
3. Available facilitates for diagnosis and treatment

Question 12

WHO has 10 principles of screening.

List
4 criteria related to the screening test itself

Answer 12

1. Test is highly accurate
2. Test is acceptable to population
3. Test has an economically balanced cost
4. Test is carried out continuously, not “once and for all”

Question 13

What is TTF1 used for

Answer 13

If negative, can rule out primary lung cancer

Positive doesn’t mean anything