Cancer Screening and Early Detection Flashcards

A patient is found to have an adenomatous polyp >10 mm removed during colonoscopy. What is the recommended surveillance interval?

Answer: 3 years

Patients with one or more advanced adenomas (≥10 mm, villous histology, or high-grade dysplasia) should have a repeat colonoscopy in 3 years due to the elevated risk of colorectal cancer compared to patients with low-risk adenomas.

Which risk factor is NOT a criterion for high-risk lung cancer screening with annual LDCT?

Answer: Non-smoker with asbestos exposure

Current USPSTF criteria for lung cancer screening with LDCT require age 50–80 and a 20 pack-year smoking history with current smoking or cessation within 15 years. Asbestos exposure alone does not qualify under the standard USPSTF criteria, though some guidelines recommend individualized consideration.

The BRCA Exchange and NCCN recommend annual MRI screening for BRCA1/2 mutation carriers beginning at what age?

Answer: Age 25–30

NCCN recommends annual breast MRI with contrast beginning at age 25–30 for BRCA1/2 carriers and other high-risk individuals. MRI detects occult tumors not visible on mammography due to dense breast tissue common in younger women.

Which biomarker is routinely elevated in hepatocellular carcinoma (HCC) and used in surveillance for high-risk patients?

Answer: Alpha-fetoprotein (AFP)

Alpha-fetoprotein (AFP) is the primary biomarker for hepatocellular carcinoma (HCC). In combination with abdominal ultrasound every 6 months, AFP surveillance is recommended for high-risk patients including those with cirrhosis or chronic hepatitis B.

A Pap smear result of ASC-H (atypical squamous cells, cannot exclude HSIL) in a 35-year-old woman should prompt which next step?

Answer: Referral for colposcopy

ASC-H (atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion) carries a significant risk of CIN 2/3 and requires immediate colposcopy regardless of HPV status, per ASCCP guidelines.

The USPSTF recommends against which cancer screening test due to insufficient evidence of benefit in average-risk asymptomatic adults?

Answer: Annual CA-125 for ovarian cancer screening in average-risk women

The USPSTF gives a D recommendation (recommend against) for ovarian cancer screening with CA-125 and transvaginal ultrasound in average-risk asymptomatic women, as evidence shows it does not reduce mortality and leads to harmful false-positive surgical interventions.