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Flashcards in Wk6 Cancer Screening Westra Deck (26):
1

Group with highest mortality rate from CRC?

African Americans

2

Only group CRC is not decreasing in:

American Indians and Alaska Natives

3

Examples of primary prevention of CRC:

1. Diet-Exercise (BMI)

2. COX-2 inhibitors

3. Calcium/vit D

4. Hormone replacement therapy

5. Statins

4

Secondary CRC prevention strategies:

GET POLYPS OUT!

95% of CRC comes from adenomatous and serrated polyps

5

What constitutes "average risk" of CRC:

No personal or FHx

Asymptomatic

6

When to start screening "average risk" for CRC?

How often follow up?

age 50 (45 for African Americans)

every tens years if scope is normal

7

Age to discontinue CRC screening:

75

8

Colonoscopy screening frequency in average risk?

every 10 years

9

Flex-sig screening for average risk; how often?

every 5 years

+/- fecal occult blood test

10

Stool DNA panel every three years?

Cologuard

-no dietary prep

-expensive

11

Cologuard compared to FIT:

More sensitive but more false positives

12

PillCam vs colonoscopy?

Colonoscopy better

13

Main patient reason for not having colonoscopy?

Fear, embarrassment

14

RF for CRC

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

15

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

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

16

Group that 75% of CRC arise in:

Average risk group

17

What is the "choosing wisely campaign"?

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

18

Symptoms of high suspicion for CRC:

anemia

weight loss

19

Ethnicity at greater risk for esophageal SCC?

African Americans

20

Ethnicity at greatest risk for esophageal adenocarcinoma:

Caucasian

21

RF for SCC:

Tobacco

EtOH

22

RF for adenocarcinoma:

GERD

Barrett's esophagus

obesity

male

23

Only real screening for Esophageal CA:

EGD

24

Likely causes of HCC in USA:

Hep C

EtOh

25

Screening options for HCC in high risk:

Alpha-fetoprotein

Abd CT -- US if CT not available

26

Dx for HCC:

biopsy