question

risk factors of cancer

answer

tobacco alcohol overweight/obesity physical inactivity genetics infections other environmental exposures

question

% of cancer diagnoses are made among men and women aged 55 and older

answer

78%

question

% of cancer cases that are preventable

answer

30-50%

question

% of cancer deaths are due to tobacco smoking and could be prevented

answer

30%

question

number of deaths averted from 1991 to 2011

answer

1.5 million

question

primary prevention

answer

prevent onset of condition -smoking cessation -HPV vaccine

question

secondary prevention

answer

detect and treat disease early to prevent morbidity and mortality -screening for cervical cancer

question

tertiary prevention

answer

treat established disease, preventing deterioration and reducing complications -chemotherapy, surgery

question

number 1 cause of preventable cancer deaths

answer

tobacco

question

is nicotine carcinogenic

answer

no, tobacco and its 4,000 chemicals are

question

tobacco related cancers

answer

lung oral cavity larynx pharynx bladder kidneys esophagus pancreas stomach cervix

question

the first surgeon general's report on tobacco and health was administered in what year

answer

1964 -steady decline -corresponding decline in cancer deaths occurred later, reflecting the delay time between exposure and the development of disease

question

smoking from 2005-2011

answer

heavy smoking declined significantly -light smoking increased

question

smoking prevalence in 2011

answer

22% among men 17% among women

question

primary prevention of smoking at the individual level

answer

education to prevent uptake smoking cessation

question

primary prevention of smoking at the population level

answer

clean air acts (restaurants, parks, bus stops) -taxes

question

1/3 of cancer cases are related to these issues and could therefore mostly be prevented

answer

diet and exercise

question

animal fat, red meat lead to these types of cancer

answer

colon, rectum, prostate -processing -iron may generate free radicals -cooking

question

fat may increase these things in the body

answer

secondary bile acids testosterone levels (prostate)

question

these are formed by cooking meat at high temps

answer

heterocyclic amines

question

these are used in meat processing

answer

nitrates, nitrites and salt form nitrosamines

question

alcohol may increase the risk of these cancers

answer

mouth, pharynx, larynx, esophagus, liver, breast -risk is dose related -5% of cancers

question

whole grains

answer

lignans-inconsistent data

question

broccoli

answer

phytochemicals

question

spinach

answer

carotenoids

question

fruits, vegetables, dry beans

answer

flavonoids

question

antioxidants

answer

beta carotene (carrots) vitamin C, elegiac acid (strawberries) anthocyanin (blueberries)

question

dietary recommendations for fruits and vegetables

answer

fruit: 1.5-2 cups vegetables: 2-3

question

median consumption of fruits and vegetables among us adults in 2013

answer

fruits: 1 vegetables: 1.7

question

US adults who met fruit and vegetable intake

answer

13% 9%

question

KS adults who met fruit and vegetable intake

answer

10% 8%

question

american cancer society recommends at least this many cups of fruits/vegetables a day for cancer prevention

answer

2.5 cups

question

cancers associated with physical inactivity

answer

breast colon prostate endometrium

question

physical inactivity reduces cancer risk by

answer

-controlling body weight -accelerating transit time for food -reducing estrogen exposure -reducing insulin and related growth factors

question

physical activity recommendations

answer

150 minutes of moderate physical activity 75 minutes of vigorous physical activity each week

question

% of us adults engaged in no leisure time physical activity

answer

26.3%

question

% of us adults who were active for more than 150 minutes

answer

50%

question

less frequent physical activity is associated with

answer

-lower educational attainment -lower income -hispanic ethnicity -black race -female gender

question

obesity contributes to 1 out of how many cancer deaths

answer

1 out of 5

question

obesity contributes to these cancers

answer

breast colon endometrium kidney esophagus (adenocarcinoma) pancreas

question

waist circumference goals to prevent cancer

answer

31.5 women 37 men

question

% of adults overweight or obese in every state

answer

55%

question

cancer deaths annually from chemical, radiation exposures in the workplace

answer

20,000

question

asbestos

answer

mining, manufacturing -contact in home, school or workplace -demolition, construction workers -risk for mesothelioma, lung cancer

question

HPV causes these cancers

answer

anogenital, oropharyngeal

question

men and women receiving HPV vaccines

answer

females: 60% (40% received all 3 doses) males: 40% (20% received all 3)

question

hepatitis B leads to these types of cancer

answer

liver, non-hodgkin lymphoma -91% coverage -hep C also leads to liver cancer, but no vaccine exists

question

Epstein barr virus thought to cause these cancers

answer

nasopharyngeal burkitt hodgkin, stomach

question

HIV thought to cause

answer

kaposi sarcoma (human herpes virus 8) non-hodgkin lymphoma

question

most commonly diagnosed type of cancer

answer

skin cancer -not included because majority are basal and squamous cell and are very treatable

question

cases of non melanoma skin cancer

answer

3.5 million

question

cases of melanoma

answer

74,000 (10,000 deaths)

question

aims of cancer screening

answer

-reduce cancer-related mortality -reduce cancer-related morbidity -detect precursors or early disease

question

when assessing a screening test, should consider the

answer

benefit/harm ratio

question

gold standard of evidence for screening

answer

prospective randomized control trial

question

explains why we use mortality instead of survival for screening tests

answer

lead time bias

question

length bias

answer

refers to the concept that cancers diagnoses between scheduled screenings are more aggressive (faster growing and have a poorer prognosis) than those diagnosed at scheduled screenings -those diagnosed at the initial screening are the least aggressive of all

question

this is indicative of overdiagnosis

answer

if screening is detecting more cases, but not preventing death

question

this is an independent panel of non-federal experts in prevention and evidence based medicine

answer

USPSTF -united states preventive services task force

question

the USPSTF recommends these services

answer

grade A and B

question

grade A

answer

high certainty that the net benefit is substantial

question

grade B

answer

high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial

question

USPSTF recommends selectively offering or providing this service

answer

grade C

question

grade C

answer

recommends to individual patients based on professional judgement and patient preferences -at least moderate certainty that the net benefit is small

question

the USPSTF recommends against this service

answer

grade D

question

grade D

answer

moderate or high certainty that the service has no benefit or that the harms outweigh the benefits

question

I statement (grade)

answer

current evidence is insufficient to assess balance of benefits and harms of service -evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined

question

recommended cancer screening tests

answer

breast colon cervical lung

question

breast screening tests

answer

mammography, clinical breast exam

question

colon screening tests

answer

stool blood testing, sigmoidoscopy, colonoscopy

question

cervical screening tests

answer

pap, visual screening

question

lung cancer screening

answer

(for high risk): lose dose spiral CT

question

biennial mammography for 50-74 grade

answer

B

question

biennial mammography for 40-49 grade

answer

C -decision should be made by individual

question

colon cancer screening grade

answer

A

question

colon cancer screening methods

answer

fecal occult blood testing (annually) or sigmoid every 5, FOBT every 3 or colonoscopy every 10

question

ethnicities that are less likely to be screened

answer

hispanic, asian, black

question

cervical screening grade

answer

A 21-65 years

question

cervical screening mechanism

answer

cytology (pap smear) every 3 years 30-65 -screening with cytology plus HPV testing every 5

question

heavy smoking means how many pack years

answer

30 pack years

question

lung cancer screening grade

answer

B -55-80

question

lung cancer screening mechanism

answer

annual screening with lose dose CT -30 pack year smoking history and currently smoke (or quit within past 15 years)

question

% of lung cancer cases attributable to smoking

answer

85%

question

lung cancer screening is estimated to apply to how many americans

answer

7 million

question

grade for prostate-specific antigen based screening (PSA)

answer

D -less than 75

question

informed decision making

answer

occurs when a man -understands the risks, benefits and alternatives of screening -participates in the decision to be screened or not at a level he desires -makes a decision consistent with his preferences and values

question

benefits of a screening test

answer

reduce morbidity reduce mortality psychological reassurance health maintenance quality of life

question

risks of screening test

answer

test itself -complications -radiation false positive results -work up testing and procedures -incorrect treament -psychological stress overdiagnosis -unnecessary treatment -psychological stress cost

question

key modifiable targets in cancer prevention

answer

tobacco lifestyle -limit exposure to environmental toxins -physical activity -healthy weight -fruits and vegetables screening uptake

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