Screening and Early Detection Review Questions

BRCA 1 and BRCA 2 mutation testing should be offered to family members of persons with features indicating an increased likelihood of a BRCA mutation. Which individuals should be considered for testing? (Select all that apply) A - A woman with multiple cases of early breast cancer in her family B - An individual with a strong family history of lung cancer C - An individual with more than one primary breast cancer D - A man diagnosed with testicular cancer E - A man or woman diagnosed with triple-negative breast cancer

A - A woman with multiple cases of early breast cancer in her family C - An individual with more than one primary breast cancer E - A man or woman diagnosed with triple-negative breast cancer

What statements are true about guaiac-based fecal occult blood test (gFOBT) and immunochemical fecal occult blood test (iFOBT) for colorectal (CRC) screening? (Select all that apply) A - Both tests require three consecutive stool samples collected by the patient at home. B - Both tests are affected by dietary intake C - The gFOBT has superior sensitivity and specificity compared with the iFOBT D - The gFOBT requires avoidance of some medications and vitamin supplements; the iFOBT is not affected by any medications E - The gFOBT is the only proven CRC screening method that is consistently effective in RCTs

A - Both tests require three consecutive stool samples collected by the patient at home. D - The gFOBT requires avoidance of some medications and vitamin supplements; the iFOBT is not affected by any medications E - The gFOBT is the only proven CRC screening method that is consistently effective in RCTs

Which of the following factors may affect the sensitivity and specificity of PSA levels? (Select all that apply) A - Presence of benign prostatic hypertrophy (BPH) B - Nonsteroidal anti-inflammatory drugs (NSAIDs) C - Inflammation D - Recent ejaculation (within 48 hours) E - Ethnicity

A - Presence of benign prostatic hypertrophy (BPH) C - Inflammation D - Recent ejaculation (within 48 hours)

Which of the following is true about a screening test's sensitivity? (Select all that apply) A - Sensitivity is a measure of the test's ability to correctly identify persons with the disease among the population screened. B - Sensitivity is a measure of the test's ability to correctly identify persons who do not have the disease among the population screened C - Sensitivity is dependent on the experience level of the person performing the procedure D - Sensitivity is highly reliant on the competency of the person interpreting the study E - A screening test that has 100% sensitivity has no false positives.

A - Sensitivity is a measure of the test's ability to correctly identify persons with the disease among the population screened. C - Sensitivity is dependent on the experience level of the person performing the procedure D - Sensitivity is highly reliant on the competency of the person interpreting the study

Which of the following are breast cancer screening recommendations using mammography? (Select all that apply) A - Women who have received thoracic (mantle) irradiation between the ages of 10 and 30 years should receive an annual mammogram or magnetic resonance imaging (MRI) starting at age 25 years. B - High-risk women (those with a greater than 15% to 20% lifetime risk or family history) should begin annual mammography at age 30 years C - Patients with lobular cancer in situ should begin mammography at 40 years D - All women age 40 years and older should have an annual mammogram E - Men with a genetic predisposition to breast cancer should receive an annual mammogram starting at age 25 years.

A - Women who have received thoracic (mantle) irradiation between the ages of 10 and 30 years should receive an annual mammogram or magnetic resonance imaging (MRI) starting at age 25 years. B - High-risk women (those with a greater than 15% to 20% lifetime risk or family history) should begin annual mammography at age 30 years D - All women age 40 years and older should have an annual mammogram

Which statement best describes lead-time bias? A - Bias that occurs in an elderly individual who has undergone screening and has been diagnosed with a slow growing cancer that may have not otherwise been detected, and treatment may not be necessary B - Bias that occurs when a cancer is diagnosed early before any symptom development, giving the appearance of improved survival when actually there is no decrease in mortality attributed to early diagnosis C - Bias that occurs when screening is more likely to pick up slower growing, less aggressive cancers that have an extended asymptomatic period and can exist in the body for longer than fast-growing cancers before symptoms develop D - Bias that occurs when a cancer is diagnosed in an individual who has better access to screening than the general population

B - Bias that occurs when a cancer is diagnosed early before any symptom development, giving the appearance of improved survival when actually there is no decrease in mortality attributed to early diagnosis

The nurse suggests to a woman at high risk for developing breast cancer that she begin annual mammography at age 30 years. This is an example of A - primary prevention B - secondary prevention C - tertiary prevention D - quaternary prevention

B - Secondary prevention

What are the facts about CT colonography (also known as virtual colonscopy)? (Select all that apply) A - This CT does not require a bowel preparation B - The test is a good alternative to colonoscopy for elderly of frail patients C - If a lesion is detected, a lower endoscopy is needed for biopsy, requiring a bowel prep D - The test is recommended every 5 years as a screening option in individuals 50 years of age or older with an average risk of colorectal cancer D - This CT may be used as a solitary screening tool

B - The test is a good alternative to colonoscopy for elderly of frail patients C - If a lesion is detected, a lower endoscopy is needed for biopsy, requiring a bowel prep D - The test is recommended every 5 years as a screening option in individuals 50 years of age or older with an average risk of colorectal cancer

Which screening test has the strongest evidence (randomized clinical trial) to decrease mortality in a defined population? A - Mammography for breast cancer B - Prostate-specific antigen (PSA) for prostate cancer C - Pap test for cervical cancer D - Colonoscopy for colorectal cancer

C - Pap test for cervical cancer

Cancer incidence is defined as A - The number of new and existing cancer cases identified in a specified population during a defined period of time B - The percentage of all individuals with cancer at a given point in time in a specified population C - The number of new cancer cases identified in a specified population during a defined period of time D - The number of cancer deaths in a population

C - The number of new cancer cases identified in a specified population during a defined period of time

Which of the following is true about genetic testing for BRCA 1 and BRCA 2 mutations? A - These mutations are responsible for approximately 50% of hereditary breast cancers B - This testing is recommended for the general population C - These mutations are responsible for approximately 5% to 10% of all breast cancers in women D - These mutations are responsible for 50% of breast cancer in men

C - These mutations are responsible for approximately 5% to 10% of all breast cancers in women

How often is a screening colonoscopy recommended for colorectal cancer prevention in individuals 50 years of age and older? A - Every 3 years B - Every 5 years C - Every 7 years D - Every 10 years

D - Every 10 years

Which of the following lung cancer screening guidelines does the American Cancer Society recommend? A - Individuals with moderate risk (age older than 50 years old with 20 or more pack-year history of smoking or second-hand smoke exposure) should be screened every 5 years using chest radiography B - Individuals with moderate risk should be screened with yearly sputum cytology and chest radiography, which is more beneficial than chest radiography alone in diagnosing lung cancer earlier C - Individuals with low risk (age younger than 50 years or less than 20 pack -year history of smoking) should be screened every 5 years with chest radiography D - Individuals between 55 and 74 years of age with at least a 30-pack-year smoking history who either continue to smoke or have quit less than 15 years ago should consider screening using low-dose computed tomography

D - Individuals between 55 and 74 years of age with at least a 30-pack-year smoking history who either continue to smoke or have quit less than 15 years ago should consider screening using low-dose computed tomography

A 64 year old African American patient was recently diagnosed with prostate cancer. He asks if his 45 year old son should be screened for prostate cancer. What should the nurse tell him? A - "Your son should receive a digital rectal examination and PSA at age 50 years." B - Your son is at an increased risk of developing prostate cancer because he is African American and has a family history, but there are potential risks versus benefits associated with screening. It's a personal preference C - I think you should ask your doctor what the screening guidelines are. They are confusing and controversial D - Your son has a few risk factors for developing prostate cancer. He is African American, he has a family history of prostate cancer, and you were diagnosed before age 65 years. He should receive a PSA and digital rectal examination now. The frequency of continued testing will depend on his PSA level. I would have him consult with his physician to gather more information.

D - Your son has a few risk factors for developing prostate cancer. He is African American, he has a family history of prostate cancer, and you were diagnosed before age 65 years. He should receive a PSA and digital rectal examination now. The frequency of continued testing will depend on his PSA level. I would have him consult with his physician to gather more information.