AOCNP Cancer Screening and Prevention 2 — Questions and Answers
Question 1: The ACS recommends that average-risk adults begin colorectal cancer screening at which age?
- 45 years (Correct answer)
- 50 years
- 40 years
- 55 years
Correct answer: 45 years
The ACS updated its recommendation in 2018 to begin colorectal cancer screening at age 45 for average-risk adults due to rising incidence in younger populations.
Question 2: Which cervical cancer screening strategy is currently recommended for average-risk women aged 30–65?
- Co-testing with Pap smear and HPV test every 5 years OR Pap smear alone every 3 years (Correct answer)
- Annual Pap smear without HPV co-testing
- HPV testing annually
- No screening after age 30 if vaccinated
Correct answer: Co-testing with Pap smear and HPV test every 5 years OR Pap smear alone every 3 years
ASCCP and USPSTF guidelines recommend co-testing every 5 years or cytology alone every 3 years for women aged 30–65 at average risk.
Question 3: Sun protection is the primary prevention strategy for which type of skin cancer?
- Melanoma and non-melanoma skin cancers (BCC, SCC) (Correct answer)
- Merkel cell carcinoma only
- CTCL (cutaneous T-cell lymphoma)
- Kaposi sarcoma
Correct answer: Melanoma and non-melanoma skin cancers (BCC, SCC)
UV radiation from sunlight and tanning beds is the primary modifiable risk factor for melanoma, basal cell carcinoma, and squamous cell carcinoma.
Question 4: The PSA screening recommendation for prostate cancer emphasizes:
- Shared decision-making with men aged 55–69 after discussing benefits and harms (Correct answer)
- Universal annual screening for all men over 40
- Routine screening of all men over 70
- No PSA testing under any circumstances
Correct answer: Shared decision-making with men aged 55–69 after discussing benefits and harms
USPSTF and ACS guidelines emphasize individualized shared decision-making for men aged 55–69, acknowledging the benefit of early detection versus overdiagnosis and overtreatment harms.
Question 5: Aspirin chemoprevention is associated with reduced risk of which cancer when taken long-term?
- Colorectal cancer (Correct answer)
- Breast cancer
- Lung cancer
- Prostate cancer
Correct answer: Colorectal cancer
Long-term aspirin use reduces colorectal cancer incidence and mortality by inhibiting COX-2-mediated prostaglandin synthesis that promotes colonic adenoma growth.
Question 6: Tobacco cessation counseling is a primary prevention intervention most critically indicated for which cancer risk reduction?
- Lung, head and neck, bladder, esophageal, and pancreatic cancers (Correct answer)
- Colorectal and prostate cancers only
- Breast cancer only
- Cervical cancer specifically
Correct answer: Lung, head and neck, bladder, esophageal, and pancreatic cancers
Tobacco is carcinogenic across multiple organ systems — smoking causes 30% of all cancer deaths and cessation reduces risk for at least 12 different cancer types.
AOCNP Cancer Screening and Prevention 2
The ACS recommends that average-risk adults begin colorectal cancer screening at which age?