Cancer Screening and Prevention Flashcards

Which hereditary syndrome requires prophylactic total colectomy due to near-100% lifetime colorectal cancer risk if untreated?

Answer: Familial adenomatous polyposis (FAP)

FAP patients develop hundreds to thousands of colonic polyps beginning in adolescence, with virtually 100% progression to colorectal cancer if colectomy is not performed.

Dense breast tissue on mammography increases breast cancer risk and also:

Answer: Reduces mammographic sensitivity, potentially requiring supplemental MRI or ultrasound

Dense fibroglandular tissue masks lesions on mammography (masking effect) and is also an independent risk factor, prompting many states to mandate notification and offer supplemental screening.

Which obesity-related mechanism most directly increases the risk of postmenopausal breast cancer?

Answer: Conversion of androgens to estrogens in adipose tissue via aromatase

Adipose tissue contains aromatase that converts adrenal androgens to estradiol, raising circulating estrogen levels in postmenopausal women and driving ER-positive breast cancer risk.

Helicobacter pylori eradication is a primary prevention strategy for which cancer?

Answer: Gastric adenocarcinoma and gastric MALT lymphoma

H. pylori is a WHO Group 1 carcinogen; chronic infection causes gastric mucosal inflammation progressing to atrophy, metaplasia, dysplasia, and ultimately gastric cancer.

Annual mammography screening for breast cancer is recommended by ACS starting at which age for average-risk women?

Answer: 45 years

The ACS recommends annual mammography beginning at age 45 for average-risk women, with the option to start at 40 if they choose after discussing benefits and harms.

Which lifestyle modification has the strongest evidence for reducing cancer risk overall?

Answer: Tobacco cessation

Tobacco cessation is the single most impactful lifestyle modification, responsible for preventing approximately 30% of all cancer deaths across multiple cancer types.