Sandbox:Cancer screening and primary care

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]

Overview

Screening

Breast Cancer

United states preventive services task force recommendations for Breast cancer screening
Population Recommendation Grade
Women, 40 Years and Older The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. I
Women, Age 50-74 Years The USPSTF recommends biennial screening mammography for women 50-74 years. B
Women, Before the Age of 50 Years The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. C
Women, 75 Years and Older The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of screening mammography in women 75 years and older. I

Breast cancer screening relevance

Studies have reported that, for women of all age groups with an average risk, breast screening was associated with a reduction in breast cancer mortality of approximately 20%, although there was an uncertainty in the quantitative estimates of outcomes for different breast cancer screening strategies in the United States.[1]

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Colon cancer

United states preventive services task force recommendations for Colon cancer screening
Population Recommendation Grade
Adults aged 50 to 75 years The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. A
Adults aged 76 to 85 years The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient’s overall health and prior screening history.
  • Adults in this age group who have never been screened for colorectal cancer are more likely to benefit.
  • Screening would be most appropriate among adults who 1) are healthy enough to undergo treatment if colorectal cancer is detected and 2) do not have comorbid conditions that would significantly limit their life expectancy.
C

Colon cancer screening relevance

Studies have reported, 40% to 60% decrease in incidence of colorectal cancer and mortality from colorectal cancer after screening colonoscopy.[2]

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Cervical cancer

United states preventive services task force recommendations for Cervical cancer screening
Population Recommendation Grade
Women 21 to 65 (Pap Smear) or 30-65 (in combo with HPV testing) The USPSTF recommends screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. A

Cervical cancer screening relevance

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Epidemiology

Genetics

References

  1. Myers ER, Moorman P, Gierisch JM, Havrilesky LJ, Grimm LJ, Ghate S; et al. (2015). "Benefits and Harms of Breast Cancer Screening: A Systematic Review". JAMA. 314 (15): 1615–34. doi:10.1001/jama.2015.13183. PMID 26501537. Review in: Ann Intern Med. 2016 Mar 15;164(6):JC26
  2. Brenner H, Stock C, Hoffmeister M (2014). "Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies". BMJ. 348: g2467. doi:10.1136/bmj.g2467. PMC 3980789. PMID 24922745.