Part 1
Always remember BEST answer and INITIAL treatment.
Topic 1= Lung cancer screening
Quick Lung Cancer Screening Criteria (USPSTF 2021):
Criteria Requirement
Age 50 to 80 years
Smoking history ≥20 pack-years
Smoking status Current smoker or quit <15 yrs ago
Screening test Annual low-dose CT
Stop screening Quit >15 years ago, poor prognosis, or age >80
if
Sample questions
Which patient meets the criteria for annual low-dose CT (LDCT) screening for
lung cancer?
A) 52-year-old, 20 pack-year smoker, quit 16 years ago
B) 68-year-old, 35 pack-year smoker, still smoking
C) 47-year-old, 25 pack-year smoker, quit 10 years ago
D) 75-year-old, 15 pack-year smoker, still smoking
Answer: B) 68-year-old, 35 pack-year smoker, still smoking
Rationale:
Current USPSTF guidelines recommend annual LDCT for adults aged 50–80 who have:
A 20+ pack-year smoking history
Currently smoke or quit within the past 15 years
2. A 72-year-old man with a 40 pack-year smoking history quit smoking 18 years
ago. Should he be screened for lung cancer?
A) Yes, he meets screening criteria
B) No, he is under the age threshold
C) No, he quit smoking more than 15 years ago
D) No, only chest X-ray is recommended
, Answer: C) No, he quit smoking more than 15 years ago
Rationale:
To qualify for screening, patient must have quit ≤15 years ago.
3. Which of the following is the recommended screening modality for lung cancer
in high-risk individuals?
A) Chest X-ray
B) PET-CT
C) Sputum cytology
D) Low-dose CT (LDCT)
Answer: D) Low-dose CT (LDCT)
Rationale:
LDCT is proven to reduce lung cancer mortality in high-risk patients. Chest X-ray is not
effective for screening.
4. A 61-year-old female smoker with COPD and a 25 pack-year smoking history
asks about lung cancer screening. What is the best course of action?
A) Order a chest X-ray
B) Recommend annual LDCT
C) Wait until age 65
D) Tell her she doesn't qualify because she's female
Answer: B) Recommend annual LDCT
Rationale:
Gender doesn’t affect eligibility. She meets all criteria:
Age: 50–80
20+ pack-years
Current smoker
5. When should lung cancer screening with LDCT be discontinued?
A) At age 70
B) Once a person quits smoking
C) At 15 years after quitting smoking
D) When life expectancy is <10 years or unable to undergo curative surgery
Answer: D) When life expectancy is <10 years or unable to undergo curative surgery
Rationale:
Screening is not beneficial if patient wouldn't tolerate curative treatment or has limited life
expectancy.