peraspera
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In addition to a checkup including health counceling and examination of the oral cavity, thyroid gland, skin, lymph nodes, testes, and prostate, which according to the American Cancer Society , of the folloving should be done annually after age 40 in the asymptomatic, average-risk man in order to promote the early detection of cancer?
A. Colonoscopy
B. Sigmoidoscopy
C. Digital rectal exam with palpation of the prostate
D. Digital rectal exam with palpation of the prostate and stool guaiac
E. Digital rectal exam with palpation of the prostate and stool blood
test, and chest x-ray
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| kpmle2
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D. Digital rectal exam with palpation of the prostate and stool guaiac
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| hanialkhadher
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C. Digital rectal exam with palpation of the prostate at 40
PSA at 50
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| elitoki
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hanialkhadher wrote:C. Digital rectal exam with palpation of the prostate at 40 PSA at 50
Also after 40 need to done FOBT annually.
Answer is D.
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| hanialkhadher
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 FOBT after 50 if no higher risk
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| kpmle2
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peraspera can u pls post the answer.
thanks.
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| DrVirgo
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I go for C.
Is this a trick question? 
What's the answer?
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| peraspera
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The answer is C ( Good job- hanialkhadher, DrVirgo)
Expl :
It is recommended that each time a patient is seen by his or her physician, cancers of the oral cavity, thyroid,skin, lymph node, testes, and prostate be considered by performance of a careful physical
examination.
Between the ages of 20 and 39 the American Cancer Society recommends that such a physical examination be performed every 3 years.
For men aged 40 to 49 a digital rectal examination with palpation of the prostate is recommended annually.
For those aged 50 and older, the annual cancer-related checkup should include a digital rectal examination and palpation of the prostate as well as annual stool blood test plus sigmoidoscopy
every 3 to 5 years. Screening for advanced prostate cancer by serologic measurement of the prostate specific antigen (PSA), while sometimes recommended for men over 50, remains controversial. It is important to recognize that for a screening test such as PSA to be effective, it must pick up disease in the curable stage. Chest radiography, for example, is not useful as a screening test for lung cancer in average-risk, asymptomatic patients because cancers that are picked up by this modality tend to be too far advanced for meaningful intervention. On the other hand, PSA detection might well pick up insignificant cancers that are unlikely to progress. Finally, it is important to recognize that a more aggressive approach to the detection of cancer is appropriate if a patient has a symptom,
an abnormal physical examination, or a strong family history.
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| kpmle2
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thanks for the explanation peraspera.
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| DrVirgo
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Good explanation...
And just to add: (this is all from UW by the way)
Prostate Cancer:
DRE for those over 50 (as peraspera says: American Cancer Society says 40, then go with that)
PSA ONLY for those with Prostate Hypertrophy on DRE (annually until 75 years old)
Routine Screening for Chlamydial infection in ALL Sexually Active females age 25 and younger, and in asymptomatic females at high risk for this infection.
For those with a higher than average risk of Ovairan Cancer, (eg Fam Hx),
SCREEN with CA-125 and Vaginal U/S (periodically)
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| peraspera
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Thanks for complement DrVirgo, but explanation belongs to
Harrison Self Assessment & Board Review. 
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