AOCNP Cancer Screening and Early Detection 1 — Questions and Answers
Question 1: According to current ONCC guidelines, which imaging modality is recommended for lung cancer screening in high-risk individuals?
- Chest X-ray annually
- Low-dose computed tomography (LDCT) annually (Correct answer)
- PET scan every 2 years
- MRI of the chest annually
Correct answer: Low-dose computed tomography (LDCT) annually
Low-dose CT (LDCT) of the chest is recommended annually for high-risk individuals (ages 50–80, 20 pack-year smoking history, current or former smoker who quit within 15 years) based on USPSTF and NCCN guidelines, as it significantly reduces lung cancer mortality.
Question 2: Which of the following tumor markers is most useful in the early detection and monitoring of ovarian cancer?
- CEA
- AFP
- CA-125 (Correct answer)
- PSA
Correct answer: CA-125
CA-125 is the primary serum biomarker used in ovarian cancer detection and monitoring. While not recommended for population screening due to low specificity, it is valuable in high-risk patients and for monitoring response to treatment.
Question 3: The Bethesda System is used to classify results from which cancer screening test?
- Colonoscopy
- Pap smear (cervical cytology) (Correct answer)
- Mammography
- PSA testing
Correct answer: Pap smear (cervical cytology)
The Bethesda System provides standardized terminology for reporting cervical cytology (Pap smear) results, categorizing findings from normal to high-grade squamous intraepithelial lesions (HSIL), which guides clinical management.
Question 4: At what age does the American Cancer Society recommend initiating average-risk colorectal cancer screening?
- 40 years
- 45 years (Correct answer)
- 50 years
- 55 years
Correct answer: 45 years
The American Cancer Society updated its guideline in 2018 to recommend colorectal cancer screening beginning at age 45 for average-risk adults, lowered from the previous recommendation of 50 years, due to increasing rates in younger adults.
Question 5: Which genetic mutation significantly elevates the lifetime risk of breast and ovarian cancer, prompting enhanced surveillance protocols?
- TP53 only
- MLH1/MSH2
- BRCA1/BRCA2 (Correct answer)
- APC gene
Correct answer: BRCA1/BRCA2
Pathogenic variants in BRCA1 and BRCA2 genes confer a lifetime breast cancer risk of 50–72% and ovarian cancer risk of 17–44%. Carriers require enhanced screening including annual MRI and mammography beginning at age 25–30.
Question 6: Which HPV strains are considered high-risk and are most commonly associated with cervical cancer?
- HPV 6 and 11
- HPV 16 and 18 (Correct answer)
- HPV 31 and 45 only
- HPV 2 and 4
Correct answer: HPV 16 and 18
HPV types 16 and 18 are the most oncogenic high-risk strains, responsible for approximately 70% of cervical cancers and a significant proportion of oropharyngeal, anal, vulvar, vaginal, and penile cancers.
AOCNP Cancer Screening and Early Detection 1
According to current ONCC guidelines, which imaging modality is recommended for lung cancer screening in high-risk individuals?