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Flashcards in Cancer Screening Deck (61)
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1

Number 1 Cancer in Males

Prostate

2

Number 1 Cancer in Females

Breast

3

Number 1 Cancer that Males & Females Die from Each Year

Lung & bronchus

4

General Cancer Prevention

Avoid tobacco
Be physically active
Maintain a healthy weight
Limit alcohol
Avoid excess sun
Eat a diet rich in fruits, veggies, & whole grains & low in sat/trans fats
Protect against STIs
Regular screening for breast, cervical, & colorectal cancer

5

Principles of Screening

Disease has high prevalence
Disease has serious consequences
Detectable pre-clinical phase
Treatment for pre-symptomatic disease more effective than after symptoms develop
Positive impact on clinical health outcomes

6

Other Considerations for General Screening

What are patient's co-morbid conditions?
Associated life expectancy, feasibility of treatment, effects of treatment on QOL?
What will you do with the results?

7

Which cancers are largely asymptomatic in the early stages?

Colorectal
Breast
Cervical

8

What is the leading cause of death from gynecologic malignancy in the U.S.?

Ovarian cancer

9

Pelvic Examination in Ovarian Cancer

No evidence they reduce mortality
Early stage tumors rarely found
Usually detected at an advanced stage & associated with a poor prognosis

10

Screening for Ovarian Cancer

CA 125 & TVUS
Family ovarian cancer syndrome or BRCA genes: CA 125 & TVUS
Initiation at 35 years or 5-10 years earlier than earliest age of first diagnosis

11

BRCA1 Carriers & Breast, Ovarian, & Contralateral Breast Cancer Risk

Breast risk: 60%
Ovarian risk: 59%
Contralateral breast risk: 83%

12

BRCA2 Carriers & Breast, Ovarian, & Contralateral Breast Cancer Risk

Breast risk: 55%
Ovarian risk: 16.5%
Contralateral breast risk: 62%

13

When to Test for BRCA for Non-Ashkenazi Jewish Women

2 1st-degree relatives with breast cancer, one

14

When to Test for BRCA for Women of Ashkenazi Jewish Descent

1st degree relative with breast or ovarian CA

15

Positive Impact on Clinical Health Outcomes for Ovarian Cancer

Annual pelvic, CA-125, and TVUS DO NOT decrease mortality from ovarian cancer

16

Prevention of Ovarian Cancer

Oral contraceptives
Gynecologic surgery: tubal, hysterectomy
Pregnancy
Breastfeeding

17

Cervical Cancer Prevention

Pap test
Death rate decreased 50% since pap administration

18

Cervical Cancer Screening Recommendations

Women should begin screening at age 21 unless HIV or immunocompromised
21-29 cytology every 3 years
30 years old: cytology every 3 years, co-testing cytology & HPV testing every 5
May stop after 65 if adequate screening in past 10 years with 2 negative screens

19

High Risk Groups for Cervical Cancer

Patients with HIV infection
Patients who are immunosuppressed
Those who had in utero DES exposure
Women who have been treated for CIN2, CIN3, or cervical cancer

20

Cervical Cancer: Hysterectomy Patients who Still Need Pap Smears

Surgery was done as treatment for cervical CA or pre-cancer
Hysterectomy without removal of the cervix

21

Cervical Cancer Prevention

Gardasil
Avoid exposure to HPV
Don't smoke
Pap smear

22

Epidemiology of Breast Cancer

Most common in U.S
Second leading cause of cancer death in women
Diagnosed as a result of abnormal screening study

23

Primary Risk Factors for Breast Cancer

Predominantly in females
Age: 85% age 50+

24

Screening Tools for Breast Cancer

Mammography
Ultrasound
MRI: high risk patients

25

Proper Clinical Breast Exam (CBE) Technique

Flatten breast tissue against chest
Examine in vertical strips
Make circular motions with pads of the middle 3 fingers
Examine each breast with 3 different pressure for at least 3 minutes

26

Epidemiology of Colorectal Cancer

3 most common cancer in U.S.
2nd leading cause of cancer-related deaths in U.S.

27

Assess Colorectal Cancer Risk

Start at age 20 & every 5 year thereafter
Have you ever had colorectal cancers or an adenomatous polyp?
Have you had inflammatory bowel disease?
Have any family members had CBC or adenomatous polyp? If so, how many were 1st degree relatives & at what age was cancer or polyp diagnosed?

28

Recommendations

Fecal occult blood test: begin at 50
Flexible sigmoidoscopy: begin at 50, every 5 years; + sensitive FOBT every 3 years
Colonoscopy: begin at 50, every 10 years
Virtual colonoscopy: every 5 years

29

FOBT

Finds blood in the stool (3 samples)
Stool guaiac
Immunochemical stool tests
Check for some intestinal conditions or colorectal cancer
+ test = colonoscopy

30

Sigmoidoscopy

View rectum, sigmoid, and last 2 feet of large intestine
Biopsies can be taken