Wk6 Cancer Screening Westra

Question 1

Group with highest mortality rate from CRC?

Answer 1

African Americans

Question 2

Only group CRC is not decreasing in:

Answer 2

American Indians and Alaska Natives

Question 3

Examples of primary prevention of CRC:

Answer 3

1. Diet-Exercise (BMI)
2. COX-2 inhibitors
3. Calcium/vit D
4. Hormone replacement therapy
5. Statins

Question 4

Secondary CRC prevention strategies:

Answer 4

GET POLYPS OUT!

95% of CRC comes from adenomatous and serrated polyps

Question 5

What constitutes “average risk” of CRC:

Answer 5

No personal or FHx

Asymptomatic

Question 6

When to start screening “average risk” for CRC?

How often follow up?

Answer 6

age 50 (45 for African Americans)

every tens years if scope is normal

Question 7

Age to discontinue CRC screening:

Answer 7

75

Question 8

Colonoscopy screening frequency in average risk?

Answer 8

every 10 years

Question 9

Flex-sig screening for average risk; how often?

Answer 9

every 5 years

+/- fecal occult blood test

Question 10

Stool DNA panel every three years?

Answer 10

Cologuard

• no dietary prep
• expensive

Question 11

Cologuard compared to FIT:

Answer 11

More sensitive but more false positives

Question 12

PillCam vs colonoscopy?

Answer 12

Colonoscopy better

Question 13

Main patient reason for not having colonoscopy?

Answer 13

Fear, embarrassment

Question 14

RF for CRC

Answer 14

Age > 50

Personal Hx of CRC or adenomas

UC/Crohn’s

Hx endometrial/ovarian/breat CA

First deg relative with CRC

First deg relative with adenoma before age 60

Question 15

When to start screening a pt with first degree relative with CRC:

Answer 15

40 … or 10 years younger than relative was at dx… whichever is earlier

Question 16

Group that 75% of CRC arise in:

Answer 16

Average risk group

Question 17

What is the “choosing wisely campaign”?

Answer 17

Do not repeat CRC screening for 10 years in average risk group after high quality negative colonoscopy

Question 18

Symptoms of high suspicion for CRC:

Answer 18

anemia

weight loss

Question 19

Ethnicity at greater risk for esophageal SCC?

Answer 19

African Americans

Question 20

Ethnicity at greatest risk for esophageal adenocarcinoma:

Answer 20

Caucasian

Question 21

RF for SCC:

Answer 21

Tobacco

EtOH

Question 22

RF for adenocarcinoma:

Answer 22

GERD

Barrett’s esophagus

obesity

male

Question 23

Only real screening for Esophageal CA:

Answer 23

EGD

Question 24

Likely causes of HCC in USA:

Answer 24

Hep C

EtOh

Question 25

Screening options for HCC in high risk:

Answer 25

Alpha-fetoprotein

Abd CT – US if CT not available

Question 26

Dx for HCC:

Answer 26

biopsy