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Lung cancer screening — MCCQE Part 1 MCQ

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ModeratePreventive MedicineLung cancer screeningMCCQE Part 1

A 69-year-old man is asymptomatic and has never been screened for an abdominal aortic aneurysm. He is sufficiently fit that elective repair could be considered if a clinically important aneurysm were found. According to the currently published Canadian Task Force recommendation, what screening approach should be discussed with him?

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Correct answer: B — One-time abdominal ultrasonography after shared decision-making

The Canadian Task Force recommends one-time ultrasound screening for abdominal aortic aneurysm in men aged 65 to 80. Ultrasound is non-invasive and is the studied screening modality; routine CT exposes patients to radiation and is not the recommended screening test, while plain radiography cannot reliably detect an aneurysm. The recommendation is weak rather than automatic because screening can identify aneurysms that would never rupture and can lead to surveillance or elective procedures. The clinician should therefore discuss potential benefits, harms and the patient's preferences. The Task Force recommends against routine screening in women and suggests not screening men older than 80, although individual circumstances may still warrant discussion.

Reference: Canadian Task Force on Preventive Health Care, Abdominal Aortic Aneurysm screening guideline, https://canadiantaskforce.ca/guidelines/published-guidelines/abdominal-aortic-aneurysm/