Cancer Screening and Control — MCQs
Which of the following is not a criterion suggesting causality in non communicable diseases?
Screening of prostate cancer is commonly done by
All of the following are risk factors for carcinoma of the gallbladder, EXCEPT -
Most common cancer worldwide among the following -
Cancer control programme was launched in India in?
National Cancer Control Programme (NCCP) in India was launched in
According to WHO Global Action Plan for prevention and control of Non-communicable Diseases 2013-2020, targeted reduction in prevalence of raised blood pressure is :
Screening for colorectal cancer is recommended when?
WHO global target for prevention and control of non-communicable diseases by 2025 is to decrease hypertension by:
Minimum age for routine screening of osteoporosis in women according to USPSTF guidelines:
Cancer Screening and Control Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following is not a criterion suggesting causality in non communicable diseases?
- A. Specificity of association
- B. Dose response relationship
- C. Strength of association
- D. Lack of temporal association (Correct Answer)
Explanation: ***Lack of temporal association*** - For an exposure to cause a non-communicable disease, the exposure must precede the disease onset; therefore, a **lack of temporal association** explicitly argues *against* causality. - This criterion is a fundamental principle of causality, as the **cause must occur before the effect**. *Specificity of association* - This criterion suggests that a single exposure should lead to a single disease. However, in non-communicable diseases, a single risk factor may contribute to multiple diseases (e.g., smoking and lung cancer, heart disease, stroke), and a single disease can have **multiple causes**. - While it was important in the original Bradford Hill criteria, its relevance is diminished in modern epidemiology due to the **multifactorial nature of chronic diseases**. *Dose response relationship* - This criterion implies that as the **amount or duration of exposure increases**, the **risk or severity of the disease also increases**. - This is a strong indicator of causality because it suggests a biological gradient. *Strength of association* - A strong association, often measured by a **high relative risk or odds ratio**, increases the likelihood of a causal relationship. - A weak association, while not ruling out causality, makes it less likely to be directly causal and more likely to be influenced by other factors or confounding variables.
Question 2: Screening of prostate cancer is commonly done by
- A. DRE (digital rectal exam) & PSA (Correct Answer)
- B. MRI imaging
- C. Surgical intervention
- D. Ultrasound-guided procedure
Explanation: ***DRE (digital rectal exam) & PSA*** - **Digital Rectal Exam (DRE)** allows for palpation of the prostate gland to detect **nodules**, **hardness**, or **asymmetry** that may indicate cancer. [1] - **Prostate-Specific Antigen (PSA)** is a blood test that measures a protein produced by the prostate gland; elevated levels can suggest prostate cancer. *MRI imaging* - While **MRI** is used for **staging** and sometimes for **targeted biopsies** of suspicious lesions, it is not a primary screening tool due to its cost and limited availability for broad population screening. - It is typically used *after* abnormal DRE or PSA results, or for monitoring. *Surgical intervention* - **Surgical intervention** (e.g., radical prostatectomy) is a **treatment** for prostate cancer confirmed by biopsy, not a screening method. - Screening aims to *detect* the disease, not to treat it. *Ultrasound-guided procedure* - **Transrectal ultrasound (TRUS)** is primarily used to **guide prostate biopsies** and determine prostate volume, not as a standalone screening test. - It does not have sufficient sensitivity or specificity to be routinely used for initial cancer screening.
Question 3: All of the following are risk factors for carcinoma of the gallbladder, EXCEPT -
- A. Adenomatous gall bladder polyps
- B. Choledochal cysts
- C. Oral contraceptives (Correct Answer)
- D. Typhoid carriers
Explanation: ***Oral contraceptives*** - While **oral contraceptives** can increase the risk of **gallstones**, they are not directly recognized as a specific risk factor for **gallbladder carcinoma**. - The impact of oral contraceptives on gallbladder cancer risk is generally considered to be minor or non-existent compared to established risk factors. *Typhoid carriers* - **Chronic asymptomatic carriers of Salmonella Typhi** have a significantly increased risk of developing **gallbladder carcinoma**, likely due to chronic inflammation and cellular damage. - The bacteria can reside in the gallbladder for years, leading to a persistent inflammatory state and genetic mutations. *Adenomatous gall bladder polyps* - **Adenomatous polyps** in the gallbladder are considered **premalignant lesions**, especially if they are larger than 10 mm, and are associated with an increased risk of progression to adenocarcinoma. - Their presence indicates a need for careful monitoring and often surgical removal due to their malignant potential. *Choledochal cysts* - **Choledochal cysts**, congenital dilations of the bile ducts, are well-established risk factors for **cholangiocarcinoma** (bile duct cancer) and, less commonly, **gallbladder carcinoma**. - The stasis and reflux of bile within these cysts lead to chronic irritation and inflammation, increasing the risk of malignant transformation.
Question 4: Most common cancer worldwide among the following -
- A. Lung (Correct Answer)
- B. Liver
- C. Kidney
- D. Prostate
Explanation: ***Lung*** - **Lung cancer** is the most common cancer worldwide, based on incidence and mortality rates [1]. - It is strongly associated with **smoking** and environmental factors [1], [2]. *Liver* - **Liver cancer** is a significant global health problem, but it ranks below lung cancer in overall incidence [1]. - Risk factors include **hepatitis B and C infections** and **alcohol abuse** [1]. *Kidney* - **Kidney cancer**, while relatively common, has a lower incidence rate compared to lung cancer [1]. - Its incidence is often higher in developed countries and is linked to **obesity and smoking** [1]. *Prostate* - **Prostate cancer** is the most common cancer among men in many Western countries, but its worldwide incidence is lower than that of lung cancer. - It is primarily seen in **older men** and is influenced by genetic and hormonal factors.
Question 5: Cancer control programme was launched in India in?
- A. 1970
- B. 1986
- C. 1976 (Correct Answer)
- D. 1992
Explanation: **1976** - The **National Cancer Control Programme (NCCP)** was officially launched in India in **1976** to address the growing burden of cancer. - Its initial focus was on **primary prevention**, early detection, treatment, and palliation of cancer cases across the country. *1970* - While there may have been some preliminary discussions or small-scale initiatives related to cancer in the early 1970s, a formal, comprehensive national cancer control programme was **not launched in 1970**. - This year generally predates the systematized approach to cancer control taken by many countries. *1986* - By **1986**, the National Cancer Control Programme was already established and undergoing **revisions and expansions** based on early experiences and evolving needs. - The year 1986 did not mark the initial launch, but rather a period of programme enhancement. *1992* - The year **1992** saw further significant **revisions and strengthening** of the NCCP, particularly in expanding district-level activities and improving infrastructure for cancer care. - However, this was a subsequent development, not the original launch year of the program.
Question 6: National Cancer Control Programme (NCCP) in India was launched in
- A. 1992
- B. 1970
- C. 1976 (Correct Answer)
- D. 1986
Explanation: ***1976*** - The **National Cancer Control Programme (NCCP)** was officially launched in India in **1976**. - Its primary objective was to provide comprehensive cancer care services, focusing on prevention, early detection, diagnosis, treatment, and palliation. *1992* - While significant revisions and expansions to the NCCP occurred in **1992**, this was not its initial launch year. - The **1992 modifications** focused on decentralization and integrating cancer control activities into primary healthcare. *1970* - The year **1970** does not mark the official launch of a national cancer control program in India. - Prior to 1976, some fragmented efforts existed, but not a unified national program. *1986* - **1986** saw further strengthening and refinement of the NCCP, but it was not the year of its inception. - This period involved efforts to enhance infrastructure and human resources for cancer care.
Question 7: According to WHO Global Action Plan for prevention and control of Non-communicable Diseases 2013-2020, targeted reduction in prevalence of raised blood pressure is :
- A. 25% (Correct Answer)
- B. 33%
- C. 10%
- D. 50%
Explanation: ***25%*** - The **WHO Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013-2020** set a target to reduce the prevalence of **raised blood pressure** (hypertension) by 25%. - This target is one of the nine global NCD targets aimed at curbing the NCD epidemic by 2025. *33%* - A 33% reduction is not a specific target for raised blood pressure in the WHO Global Action Plan for NCDs. - While significant reductions are sought across various NCD risk factors, this exact percentage isn't linked to hypertension prevalence. *10%* - A 10% reduction is generally considered too low for the ambitious goals set by the WHO for major NCD risk factors like raised blood pressure. - The plan aims for more substantial public health impact. *50%* - A 50% reduction in the prevalence of raised blood pressure is a very ambitious target, even beyond the scope of initial global NCD goals for this particular indicator. - While desirable, it was not the specific target set for raised blood pressure in the 2013-2020 action plan.
Question 8: Screening for colorectal cancer is recommended when?
- A. The condition has a low case fatality rate.
- B. Diagnostic tools are not available.
- C. There is no effective treatment available.
- D. Early diagnosis can change the disease course due to effective treatment. (Correct Answer)
Explanation: ***Early diagnosis can change the disease course due to effective treatment.*** - Screening is primarily recommended when **early detection** allows for interventions that effectively alter the natural history of the disease, improving prognosis or preventing progression. - For colorectal cancer, early diagnosis through screening allows for timely removal of **precancerous polyps** or early-stage cancers, significantly increasing survival rates. *The condition has a low case fatality rate.* - Conditions with low case fatality rates generally do not warrant extensive screening programs, as the **benefit-to-harm ratio** is often unfavorable. - Colorectal cancer, if undiagnosed and untreated, has a significant **case fatality rate**, making screening beneficial. *Diagnostic tools are not available.* - Screening is only conducted when **reliable, accurate, and cost-effective diagnostic tools** are available to detect the disease or its precursors in asymptomatic individuals. - If diagnostic tools are unavailable, screening would be impossible or ineffective, as there would be no way to identify those with the condition. *There is no effective treatment available.* - Screening is not typically recommended for diseases for which there is **no effective treatment**, as early detection would not improve patient outcomes. - The primary purpose of screening is to identify individuals who can benefit from **early intervention** and treatment to prevent serious morbidity or mortality.
Question 9: WHO global target for prevention and control of non-communicable diseases by 2025 is to decrease hypertension by:
- A. 25% (Correct Answer)
- B. 55%
- C. 75%
- D. 35%
Explanation: ***25%*** - The World Health Organization (WHO) set a **global target** to reduce the prevalence of high blood pressure (hypertension) by **25%** among individuals aged 18+ years by 2025, from a 2010 baseline. - This target is part of a broader WHO effort to combat **non-communicable diseases (NCDs)** and improve global health outcomes. *55%* - This percentage is not recognized as a specific WHO global target for the reduction of hypertension prevalence. - The NCD targets generally focus on more achievable and evidence-based reductions to ensure global feasibility. *75%* - A 75% reduction in hypertension prevalence is an exceptionally ambitious target that has not been set by WHO for the 2025 timeframe. - Such a drastic reduction is typically not seen in global public health goals due to the complex nature of NCDs and their determinants. *35%* - While significant, a 35% reduction is not the specified WHO global target for hypertension by 2025. - The established target reflects a balance between ambition and realistic attainability across diverse global health systems.
Question 10: Minimum age for routine screening of osteoporosis in women according to USPSTF guidelines:
- A. 55 years
- B. 60 years
- C. 50 years
- D. 65 years (Correct Answer)
Explanation: ***65 years*** - The **U.S. Preventive Services Task Force (USPSTF)** recommends routine osteoporosis screening with **bone mineral density (BMD) testing** for all women aged 65 years and older. - This recommendation is based on evidence that screening in this age group can effectively reduce the risk of **osteoporotic fractures**. *55 years* - This age is **too early** for routine osteoporosis screening in women according to current USPSTF guidelines. - Screening before age 65 is recommended only for younger women at **increased risk** of osteoporosis. *60 years* - This age is also **too early** for routine osteoporosis screening in women without additional risk factors. - The benefits of universal screening typically outweigh the harms beginning at age 65. *50 years* - This age is generally considered **too young** for routine osteoporosis screening. - Women in this age group are often still premenopausal or early postmenopausal and typically do not have a sufficiently high risk to warrant routine screening.
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