Term
| What ages is colorectal cancer recommended for? |
|
Definition
| 1) 50-75y/o (average risk adult; no FHx) |
|
|
Term
| What is the precursor lesion for colorectal cancer (majority) |
|
Definition
| - adenomatous polyps (30% of 50+y/o) |
|
|
Term
| What is an "average risk adult"? |
|
Definition
| - an asymptomatic person without a personal or family history of adenomatous polyps or other illness that predisposes to the condition in question |
|
|
Term
| What screening methods are cost effective for colorectal cancer? |
|
Definition
| - all screening methods are cost-effective (less than 30k/additional year of life gained) |
|
|
Term
| What has been the impact of office testing of stool samples obtained by digital rectal examination? What is the recommended change to this practice? |
|
Definition
1) this test has not been shown to reduce mortality; will miss 95%; NOT recommended
2) pts given 3 cards (2 windows/crd) to use 1crd/d for 3d
*standard guaiac-based testing Hemoccult II) |
|
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Term
| If flexible sigmoidoscopy is selected as the colorectal cancer screening test, what frequency should it be executed? What could be combined with flex-sig |
|
Definition
1) q5yrs
2) high-sensitivity FOBT q3yrs |
|
|
Term
| What population would receive less benefit from flex-sig as a screen compared to average-risk |
|
Definition
| 1) women, twice as likely to have unidentified polyp |
|
|
Term
| Why is colonoscopy preferred to other screening modalities |
|
Definition
| - has superior single-test accuracy |
|
|
Term
| What frequency should colonoscopy be performed as a screening measure |
|
Definition
| - once every 10 years for average-risk persons |
|
|
Term
| How can colonoscopy decrease the incidence of colorectal cancer |
|
Definition
|
|
Term
| What are the major risks associated with colonoscopy |
|
Definition
- greater risk of perforation
- conscious sedation used, inc RR CardioPulm complications
- complete bowel prep is necessary |
|
|
Term
| What is a major use of double-contract barium enema in screening? |
|
Definition
- used for R sided colon assessment following incomplete colonoscopy
- low perforation risk |
|
|
Term
| Compare fecal DNA testing compared to FOBT for screening |
|
Definition
- four times more sensitive than FOBT
- twice as sensitive for detecting adenomatous polyps w/ high-grade dysplasia |
|
|
Term
What is the effect of the following on colon cancer risk:
obesity
fat intake
red meat
fiber
NSAIDS
Calcium
Vitamin D
antioxidants
statins |
|
Definition
1) inc RR w/ inc BMI
2) inc RR w/ inc fat intake
3) conflicting evidence
4) failed to show benefit**
5) dec RR w/ use; balance w/ s/e profile
6) modest reduction
7) dec RR; NOT chemoprevention
8) no benefit**
9) dec RR after 5yrs; need randomized trial |
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