278: Cancer Screening Flashcards

Screening recommendations based on updated USPSTF guidelines.

1
Q
A

D - Routine screening is not recommended

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2
Q
A

C

  • People 55 - 80 with 20 pack year smoking hx who currently smoke or quit <15 years ago*
  • Screen with low dose CT*
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3
Q

Who should be screened for colon cancer?

A
  • Age 45*-75
    • *Previously 50
  • Earlier if family hx is suggestive

No one screening method is recommended over another

FOBT or FIT yearly

FIT-DNA every 3 years

Colonoscopy every 10 years

CT colonography or flexible sigmoidoscopy every 5 years

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4
Q
A

C

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5
Q

Is it recommended to teach patients how to do breast self-exams

A

No

In fact, it is recommeded against!

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6
Q

Who should be screened for cervical cancer?

A

People 21-65

  • 21-29
    • PAP every 3 years
  • 30-65 (1 of the following)
    • PAP every 3 years
    • CO-testing every 5 years
    • hrHPV alone every 5 years
  • Stopping at age 65 relies on normal PAP for the last 10 years
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7
Q

Which USPSTF grades recommend that we should “offer or provide this service”?

A

A or B

C means individualized

D don’t do it

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8
Q

What kind of bias:

People live longer after diagnosis, but it’s because they were diagnosed early in the course of the diseae (not because the treatment works)

A

Lead-time bias

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9
Q

What are the current guidelines for breast cancer screening?

A

Mammogram every 2 years

  • Start at age 50
    • Individualize decision for 40-49
  • Stop at age 74
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10
Q

What is the best way to avoid lead time and lenth time bias in cancer screening trials?

A

Use cancer-specific mortality rates

Instead of survival rates, rates of dx

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11
Q
A

A

Can use any of the following:

  • FOBT or FIT yearly
  • FIT-DNA every 3 years
  • Colonoscopy every 10 years
  • CT colonography or flexible sigmoidoscopy every 5 years
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12
Q

What kind of bias:

People with aggressive disease present with symptoms and die quickly, while people with indolent disease are detected on screening - this makes it look like screening is effective, when in reality it’s just detecting cancers with better prognosis

A

Length time bias

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13
Q
A

D

Screen people 21-65

  • 21-29
    • PAP every 3 years
  • 30-65 (1 of the following)
    • PAP every 3 years
    • CO-testing every 5 years
    • hrHPV alone every 5 years
  • Stopping at age 65 relies on normal PAP for the last 10 years

New guidelines are suggesting starting screening at age 25 instead of 21`

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14
Q

Who should be screened for lung cancer?

A

People with all of the following:

  • 55 - 80 years old
  • 20+ pack year smoking hx who currently smoke or quit <15 years ago
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15
Q

What are the recommended age ranges for breast, cervical, colon and lung cancer screening?

A
  • Breast: 50-74 (individualized for women age 40-49
  • Cervical: 21-65
  • Colon: 45-75
  • Lung: 55-80
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