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Year : 2021  |  Volume : 58  |  Issue : 3  |  Page : 425--427

MCQs on “Feasibility, uptake and real-life challenges of a rural cervical and breast cancer screening program in Vellore, Tamil Nadu, South India”

HS Darling1, Pradeep Jaiswal2, Nishant Lohia3, Nishant R Tiwari4,  
1 Department of Medical Oncology and Hemato-Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
2 Department of Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
3 Department of Radiation Oncology, Command Hospital, Lucknow, Uttar Pradesh, India
4 Department of Internal Medicine, B.J. Government Medical College, Pune, Maharashtra, India

Correspondence Address:
H S Darling
Department of Medical Oncology and Hemato-Oncology, Command Hospital Air Force, Bangalore, Karnataka
India




How to cite this article:
Darling H S, Jaiswal P, Lohia N, Tiwari NR. MCQs on “Feasibility, uptake and real-life challenges of a rural cervical and breast cancer screening program in Vellore, Tamil Nadu, South India”.Indian J Cancer 2021;58:425-427


How to cite this URL:
Darling H S, Jaiswal P, Lohia N, Tiwari NR. MCQs on “Feasibility, uptake and real-life challenges of a rural cervical and breast cancer screening program in Vellore, Tamil Nadu, South India”. Indian J Cancer [serial online] 2021 [cited 2021 Dec 8 ];58:425-427
Available from: https://www.indianjcancer.com/text.asp?2021/58/3/425/326416


Full Text

Q 1. Correct statement regarding human papillomavirus (HPV) and cervical cancer is

HPV 16 and HPV18 are associated with about 45% of all cervical cancersHPV16 is predominantly associated with squamous cell carcinomas (SCC), while HPV18 is more often detected in adenocarcinomasHPV16 is predominantly associated with adenocarcinoma, while HPV18 is more often detected in SCCTo date, 23 HPV genotypes have been identified

Q 2. All are correct regarding visual inspection of cervix for cancer screening, except

Visual inspection test uses 10–20% acetic acidVisual inspection test uses Lugol's iodineThis test is simple, cheap, and easy to useIt is a satisfactory alternative screening approach in resource poor settings

Q 3. What views are used in screening mammography?

Craniocaudal and mediolateral obliqueDouble spot compression viewMagnification viewTrue lateral view

Q 4. What is true for BIRADS “0” in mammography?

Normal breast with negative findingNegative mammography but with a benign findingNeeds additional imaging evaluationThere is no such category

Q 5. According to the National Family Health Survey (NFHS)-4 report, what percentage of women in the rural area of India have ever undergone a screening for breast cancer?

20.9%36.5%16.2%8.8%

Q 6. In this study by Jeyapaul et al., how many cervical and breast cancer or precancerous lesion cases were detected through screening of the study population?

Six cervical cancer cases, Six breast cancer casesSix cervical cancer cases, three breast cancer casesSix cervical cancer cases, zero breast cancer casesZero cervical cancer cases, Six breast cancer cases

Q 7. Which of the following national health programs implemented by the Government of India aim to provide opportunistic cervical and breast cancer screening through primary healthcare services?

National Cancer Prevention ProgramNational program for prevention and control of cancer, diabetes, cardiovascular diseases, and strokeNational program for prevention of noncommunicable diseasesNone of the above

Q 8. Incorrect statement about verbal autopsy is

It is a tool for ascertaining and attributing causes of deathIt is best used for institutional deathsIt is an internationally standardized methodA software is used by a trained person

Q 9. Rather than attending the educational session themselves, almost………… of the women attending the screening clinic had come because of information obtained from others

50%none10%35%

Q 10. In the present study, yield of screen detected cancerous/precancerous lesion was

0.03%3.3%0.33%10%

Answers and explanations:

1. (b) HPV16 is predominantly associated with SCC, while HPV18 is more often detected in adenocarcinomas.

HPV16 and HPV18 are associated with about 70% of all cervical cancers. HPV16 is predominantly associated with SCC, while HPV18 is more often detected in adenocarcinomas. To date, more than 200 HPV genotypes have been identified, based on at least 10% difference within the conserved L1 gene sequence (Lagstrom S, Lovestad AH, Umu SU, Ambur OH, Nygård M, Rounge TB, Christiansen IK. HPV16, and HPV18 type-specific APOBEC3 and integration profiles in different diagnostic categories of cervical samples. Tumour Virus Res. 2021 Jun 25; 12:200221)

2. (a) Visual inspection test uses 10–20% acetic acid

Visual inspection tests with 3–5% acetic acid (VIA) and/or Lugol's iodine (VILI) appear to be a satisfactory alternative screening approach to cytology. They are simple, cost-effective with relative ease of use, and may be performed by different healthcare workers (physicians, nurse, midwives and technicians). (Catarino R, Petignat P, Dongui G, Vassilakos P. Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices. World J Clin Oncol. 2015; 6 (6):281-290)

3. (a)Craniocaudal and mediolateral oblique

Screening mammography refers to routine mammographic images in asymptomatic women and consists of two views: Craniocaudal and mediolateral oblique of each breast. A recommendation for additional imaging evaluation includes the use of spot compression, magnification, special mammographic views, ultrasound, and so forth. (Goyal S, Buchholz T, Haffty BG. Chapter 59: Breast Cancer: Early Stage. In: Halperin EC, Brady LW, Wazer DE, Perez CA, eds. Perez and Brady's principles and practice of radiation oncology. 7th ed. Philadelphia: Wolters Kluwer, 2018).

4. (c) Needs additional imaging evaluation

Category 0 – Finding for which additional imaging evaluation is needed. This is almost always used in a screening situation and should rarely be used after a full imaging workup. A recommendation for additional imaging evaluation includes the use of spot compression, magnification, special mammographic views, ultrasound, and so forth.

(Goyal S, Buchholz T, Haffty BG. Chapter 59: Breast Cancer: Early Stage. In: Halperin EC, Brady LW, Wazer DE, Perez CA, eds. Perez and Brady's principles and practice of radiation oncology. 7th ed. Philadelphia: Wolters Kluwer, 2018).

5. (d) 8.8%

As mentioned in the introduction of the manuscript, according to the NFHS-4 report published in the year 2015–16, only 8.8% of the women in rural India were reported to have undergone the breast cancer screening. This could be attributed to the scarcity of the healthcare facilities in the rural areas.

6. (c) Six cervical cancer cases, zero breast cancer cases

As mentioned in the results section of the main text of the manuscript, the methods entailed in this study could identify six cervical cancer cases and zero breast cancer cases on screening. It will be interesting and helpful to follow-up this study with larger studies in that, they will be testament for the increasing diagnostic yield.

7. (b) National program for prevention and control of cancer, diabetes, cardiovascular diseases, and stroke

As mentioned in the discussion section of the main text of the manuscript, National program for prevention of cancer, diabetes, cardiovascular diseases, and stroke (NPCDCS), a program launched in 2010 by the Government of India aims at strengthening infrastructure, early diagnosis, referral, and management of the selected noncommunicable diseases.

8. (b) It is best used for institutional deaths

Verbal autopsy (VA) is a method of determining individuals' causes of death and cause-specific mortality fractions in populations without a complete vital registration system. Verbal autopsies consist of a trained interviewer using a questionnaire to collect information about the signs, symptoms, and demographic characteristics of a recently deceased person from an individual familiar with the deceased.

Verbal Autopsy (VA) Institute for Health Metrics and Evaluation [Internet]. [cited 2021 Aug 16]. Available from: http://www.healthdata.org/verbal-autopsy

9. (d) 35%

Although our educational sessions were estimated to have covered around only 10% of the target population, more than a third of those who attended the clinic had come because of information obtained from others, having missed the educational session themselves.

10. (c) 0.33%

As mentioned in the results section of the main text of the manuscript, while 5.5% of those screened were detected as VIA positive by the screening doctor, the final yield of cancer/pre-cancerous lesions was 3.37/1,000.