Westra: GI Epidemiology Flashcards
Average-risk, asymptomatic individuals-both men and women-should be offered screening for colorectal cancer beginning at age 40.
a. True
b. False
False
Which two colorectal cancer screening options are most highly recommended by the US Preventative Task Force?
a. FOBTs annually
b. Flexible sigmoidoscopy every five years
c. Both annual FOBTs and flexible sigmoidoscopy every five years
d. Double contrast barium enema every five years
e. Colonoscopy every ten years
c. Both annual FOBTs and flexible
e. Colonoscopy every ten years
About 95% of all colorectal cancers arise in benign adenomatous polyps.
a. True b. False
True
Direct colonoscopy screening should be reserved only for those who are at above average risk for colorectal cancer
a. True
b. False
False
Patients with HNPCC (Hereditary Nonpolyposis Colorectal Cancer) do not
develop polyps.
a. True
b. False
False
Surveillance colonoscopy for persons in an HNPCC family should occur:
a. every 3 years b. every 5 years c. every two years starting at age 25 annually after age 40 d. every 10 years
c. every two years starting at age 25 annually after age 40
Genetic testing for HNPCC is a research tool and not available for clinical use.
a. True b. False
False
Colon cancer is the second-leading cause of cancer related deaths in the U.S.
a. True b. False
True
Colon cancer screening is currently widely embraced by the general population, with 80% of those over 50 having been screened.
a. True b. False
False
Stool-based DNA tests detect only about 60% of existing colorectal cancers.
a. True b. False
false
52 year old female in good health presents to your office for a yearly examination including pap smear and breast exam. She is on no medications. Her family history is negative for breast cancer, colon cancer and diabetes. Her Hemoglobin is 14.5 gm/dl
What prevention strategies would you recommend for her regarding colorectal cancer?
Flex Sigmoidoscopy + FOBT including rectal exam
Colonoscopy q 10 years including rectal exam
What is the diff bewteen primary and secondary prevention in regards to CRC?
PRIMARY PREVENTION – changing the environment
SECONDARY PREVENTION – attacking the precursor of the disease – benign colonic polyp
What is primary prevention in CRC?
Diet-Exercise (BMI) ASA/NSAIDs/Cox-2 Inhibitors Calcium/Vitamin D Hormone Replacement Therapy Statins
What is secondary prevention in CRC?
Polyp/Cancer Relationship Neoplastic: Adenomatous and Serrated Polyp
Non-neoplastic: Hyperplastic Polyp
95% of CRC arises in adenomatous and serrated polyps over time
What are screening standards for pts at average risk for CRC?
No personal or family history No signs or symptoms Begin at age 50 Begin at age 45 in African Americans Individualize and discontinue when indicated by age, comorbidity-age 75
What are CRC screening measures in regards to stool testing?
Guaic-based fecal occult blood test (gFOBT) every year
Immunochemical-based fecal occult blood test (iFOBT) or fecal immunochemical test (FIT) every year
Stool DNA panel (sDNA): Cologuard every 3 years
What percentage of americans over the age of 50 undergo screening for CRC?
40%
What are RFs for CRC?
Age >50
Personal Hx of CRC or adenomas
Personal Hx of long-standing ulcerative colitis or Crohn’s disease
Personal Hx of ovarian, endometrial, breast ca
First-degree relative with CRC
First-degree relative with adenoma before 60