Master the board step 3

Master the Boards: USMLE Step 3
Colon Cancer Screening
Colon cancer screening is started with a colonoscopy at age 50 and is performed
every 10 years.
Other forms of colon cancer screening, such as sigmoidoscopy, barium enema,
or stool for fecal occult blood testing, are not as effective in detecting cancer as
colonoscopy. Virtual colonoscopy with CT scanning is not accurate.
If a close family member has had the disease then screening should begin
at 40 or 10 years earlier than the family member was diagnosed, whichever is
earlier. Hereditary nonpolyposis colon cancer syndrome (HNPCC), known
formerly as Lynch syndrome, is defined as colon cancer in 3 family members
in 2 generations having the disease, with 1 having it prematurely (defined as
occurring before the age of 50). In this case, screening should begin at age 25
and be done every 1–2 years.
Prostate Cancer Screening
There is no recommendation to screen patients routinely for prostate cancer
with either a prostate-specific antigen (PSA) or a digital rectal examination.
There is specific evidence to recommend against the PSA for men > 75 on the
basis that they will accrue the disadvantages of treatment, such as erectile dysfunction
or incontinence, without any benefit.
Vaccinations
Influenza and Pneumococcal Vaccine
The indications for influenza vaccination and pneumococcal pneumonia vaccination
have a lot of overlap:
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Patients with chronic lung, heart, liver, kidney, and cancer conditions
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HIV-positive patients
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Patients on steroids
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Patients with diabetes
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