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Aspirin for preeclampsia prevention — USMLE Step 2 CK MCQ

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EasyPreventive Medicine & BiostatisticsAspirin for preeclampsia preventionUSMLE Step 2 CK

A 58-year-old man with no respiratory symptoms has smoked 1.5 packs of cigarettes daily for 20 years and continues to smoke. He has no history of lung cancer and is healthy enough to undergo curative treatment if cancer is found. Which lung-cancer screening strategy is recommended?

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Correct answer: C — Annual low-dose computed tomography of the chest

He is 58 years old, currently smokes, and has a 30 pack-year history, so he meets USPSTF criteria for annual low-dose chest CT screening. Screening should occur after shared decision-making that addresses benefits, false-positive findings, downstream procedures, radiation exposure, and smoking cessation. Chest radiography and sputum cytology have not shown the mortality benefit required for screening. PET is used to characterize or stage selected abnormalities, not to screen asymptomatic people. Waiting for symptoms forfeits the purpose of screening, which is detection at a potentially curable stage. Annual screening stops when a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to undergo curative lung surgery. Smoking cessation counseling remains essential and is not replaced by CT screening.

Reference: U.S. Preventive Services Task Force. Lung Cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening