Ch. 1 Epidemiology, Prevention and Health Promotion
There are 15.5 million patients with cancer living as survivors in the United States. A statistical breakdown of cancer survivors reveals: A. Almost 60% of survivors are age 65 years or older B. African Americans have higher relative survival rates than whites C. The greatest increase in five-years survival rates is for cases of lung cancer D. Relative survival rates decreased for patient with chronic myeloid leukemia.
A. Almost 60% of survivors are age 65 years or older Rationale: According to the American Cancer Society, as of 01/01/16, 59% of cancer survivors are 65 years of age or older. African Americans do not have higher relative survival rates than whites; they have higher death rates for most cancer. Five-year survival rates have not increased for lung cancer; it is among the cancers with the lowest survival rates (18%), along with liver cancer (185) and cancer of the pancreas (5%). Relative survival rates for patients with chronic myeloid leukemia have not decreased, rather they have increased from 22% in the mid-1970s to 68% in 2013.
As of 2006, the US Food and Drug Administration (FDA) classified Electronic nicotine delivery system (ENDS), also known as e-cigarettes, as a tobacco product, bringing them under FDA regulation. Of the following, which statement is true regarding the use of ENDS? A. as of 2016, more than 2 million middle and high school age students were identified as e-cigarettes users, with a variety of appealing flavors cited as the primary reason for use. B. As of 2016, the US Food and Drug Administration (FDA) has approved e-cigarettes as a cessation aid. C. E-cigarettes are battery-operated devices in which the inhaled vapor is produced from cartridges that contain flavoring and other chemicals, but has not been found to contain any nicotine, like in traditional tobacco products. D. Use of e-cigarettes has so far not been linked to leading non-smokers and children to begin smoking.
A. As of 2016, more than 2 million middle and high school age students were identified as e-cigarettes users, with a variety of appealing flavors cited as the primary reason for use. Rationale: As of 2016, more than 2 millions middle and high school age students were identified as e-cigarette users, with a variety of appealing flavors cited as the primary reason for use. This increase in use of teens and young adolescents has given rise to parental warnings of school-age students over the use of e-cigarettes and a restriction on the types of flavors that can be manufactured sold to minors. The other responses are cigarettes. As of 2016, the US Food and Drug Administration (FDA) has not approved e-cigarettes as a cessation aid. Nicotine is found in e-cigarettes, in which the inhaled vapor is produced from cartridge that contain flavoring and other chemicals. Use of e-cigarettes has been linked to leading non-smokers and children to begin smoking.
The Federal Drug Administration (FDA) has approved drug treatments to reduce the risk of breast cancer in the general population. These drugs include which of the following: A. raloxifene B. diethylstilbestrol c. anabolic steriods d. menotropins
A. raloxifene Rationale: Tamoxifen and raloxifene are FDA-approved for use as chemoprevention agents to reduce risk of breast cancer. These agents have been shown to reduce breast cancer incidence by up to 50% among high-risk women. The other drugs are not indicated for chemoprevention of breast cancer. In the past, diethylstilbestrol use during pregnancy has been associated with cancer of the vagina in female offspring. Anabolic steriods may be associated with liver cancer. Menotropins are fertility drugs that may increase the risk of ovarian cancer.
Which of these findings is accurate about disparities in cancer epidemiology among different eterm-4thic groups in the United States? A. Asians/Pacific Islanders have the highest incidence and death rates of all groups for kidney cancer. B. African American Men are more than twice as likely as white men to die from prostate cancer. C. White women have higher mortality rates for breast cancer than African American women. D. Hispanic/Latina women have the lowest incidence rate for cervical cancer but the highest death rate.
B. African American men are more than twice as likely as white men to diet from prostate cancer. Rationale: For prostate cancer, African American men have the highest incidence and mortality rates as compared with other ethnic groups in the US and are more than twice as likely as white men to die from prostate cancer. Asians/ Pacific Islanders have the highest incidence and death rates of all groups for cancers of the liver and stomach, not kidney cancer. While white women have had the highest incidence rate for breast cancer, African American women have the highest mortality rate for breast cancer. Hispanic/Latina women have the highest incidence rate for cervical cancer, but the highest mortality rate is seen among African American women.
Maintaining a health weight is considered to be an important strategy in effort to promote general health in the United States. Overweight populations and people who are obese continue to be one of the largest concerns in promoting general health because: A. Obesity and being overweight are responsible for 50% of cancer deaths B. Obesity and being overweight are linked to cancers of the gastrointestinal system C. Obesity and being overweight are associated with increased risk for cancers of the lung D. The highest prevalence of obese and overweight people is in non-Hispanic white women
B. Obesity and being overweight are linked to cancers of the gastrointestinal system Rationale: Cancers of the GI system (ie those of the esophagus, liver, stomach, pancreas, gallbladder and colorectum) are among cancers linked to overweight and obesity. Lung Cancer risk are not elevated in obesity. Overweight and/or obesity contribute to an estimated 20% of all deaths due to cancer. African American women have the highest rates of obesity (58%) compared with non-Hispanic white women (38%).
According to stats from the American Cancer Society, several factors contribute to cancer mortality in the United States. Factors such as age, gender, geography, and socioeconomic status play a role in cancer deaths. Regarding socioeconomic status, which of the following is true regarding the cancer mortality in poorer populations? A. High socioeconomic status is associated with increased risk of lung cancer, cervical cancer, stomach cancer, and cancer of the head and neck B. The use of alcohol has increased among poorer populations, leading to a higher rate of cancer mortality C. A higher rate of advanced disease is found at diagnosis among poorer populations and those who live in rural regions that in the rest of the US population D. Low SES is associated with increase risk of breast, prostate and colon cancers.
C. A higher rate of advanced disease is found at diagnosis among poorer populations and those who live in rural regions that in the rest of the US population Rationale: According to the American Cancer Society, a fact that is true regarding cancer mortality in populations with low socioeconomic status is that there is higher rate of advanced disease is found at diagnosis among poorer populations and those who live in rural regions than in the rest of the US population. The other answers are all false. Instead of high socioeconomic status being associated with increased risk of lung cancer, cervical cancer, stomach cancer, and cancer of the head and neck, it is low socioeconomic status that is a contributor. The use of alcohol is not a leading cause of cancer mortality in poorer populations, but tobacco use is and is increasing in person from lower socioeconomic status. High socioeconomic status is associated with increased risk of breast, prostate, and colon cancers.
Cancer epidemiology is defined as the study of the: A. Rates of cancer occurrence in a population B. Number of death from cancer in a given time period C. Distribution and determinants of cancer in a population D. Most common types of new cancer cases diagnosed each year
C. Distribution and determinants of cancer in a population Rationale: Cancer epidemiology is defined as the study of the distribution and determinants of cancer in a population groups. The rates of cancer occurrence in a population indicates the incidence of cancer, usually reported for a given period of time. Number of deaths is the mortality rates for cancers over a given period of time.
Tobacco cessation is an important focus of education about cancer prevention in the United States because: A. Smokeless tobacco products are an approved alternative to cigarettes. B. Adults with college degree are most likely to use tobacco products. C. Tobacco use is the greatest modifiable risk factor for cancer. D. Smoking prevalence has increase in the past 10 year.
C. Tobacco is the greatest modifiable risk factor for cancer Rationale: Tobacco is the single largest preventable cause of disease and premature death in the US and is associated with approximately 480,000 premature death each year. Smokeless tobacco is not a safe alternative to cigarettes. It is associated with increased risk of oral, pancreatic, and esophageal cancers. Adults without a high school degree are 2 to 4 times more likely to be current smokers than those with a college degree. Daily smoker prevalence has not increased but has decreased between 2005 to 2015.
Ms. P is a 40-year-old women, who has identified herself as a smoker, and who is undergoing a preventive cancer risk assessment. A thorough medical history and physical examination is being conducted, and she is being assed for motivation for prevention behavior as per the health belief model. Which of the following questions should be asked during the motivation for preventative behavior assessment? A. "Do you currently have any medical conditions and what medications for those medical conditions are you currently taking?" B. "Have you are anyone in your immediate family ever been diagnosed with cancer?" C. "Have you ever undergone treatments for cancer such as chemotherapy, radiation therapy, or immunotherapy?" D. "How difficult do you think it will be to decrease your risk for cancer by quitting your smoking habit?"
D. "How difficult do you think it will be to decrease your risk for cancer by quitting your smoking habit?" Rationale: When accessing, Ms. P for motivation for preventative behavior as per heath belief model, she should be asked the question, "How difficult do you think it will be to decrease your risk for cancer by quitting your smoking habit?" Since Ms. P as a smoker, her healthcare provider would have recognized that smoking is an unhealthy behavior that could lead to a diagnosis of cancer. Under the the health belief model, her healthcare provider would want to know what barriers exist in her overcoming harmful habits. Asking about current medical conditions and medications, her own and her family's history cancer diagnoses, and previous treatments, such as chemotherapy, radiation therapy, and immunotherapy would all be asked during earlier medical history and physical examinations.
Which of the following types of cancers have an increasing annual incidence trend in the United States? A. Breast and Ovary B. Lung and prostate C. Stomach and Larynx D. Kidney and Pancreas
D. Kidney and Pancreas Rationale: Cancer incidence rates have been decreasing or stable from 2005 to 2014 for cancers of the breast, ovary, lung, prostate, stomach and larynx. However, during this timeframe, annual cancer incidence has been increasing for cancers of the kidney and pancreas, as well as for melanoma, and cancers of the thyroid, liver and bile duct
For which of the following groups is the vaccination for chemoprevention of human papilloma virus (HPV) recommended? A. Vaccination is recommended for female children only B. Vaccination is recommended for all sexually active adult men and women over the age of 26 years C. Vaccination is recommended to be given to girls between the ages of 15 and 18 as a single dose D. To begin in children aged 11 or 12 years as a two-dose series.
D. To begin in children aged 11 and 12 years as a tw-dose series Rationale: Vaccination against HPV is recommended for all children aged 11 or 12 years given in 2 doses separated by 6 months. HPV vaccine is not reserved for female children only and can be given to males and females as early as age 9 and as late as age 26. Over age 15, a three-dose series is recommended
