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Colorectal cancer screening — USMLE Step 3 MCQ

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HardPreventive Medicine, Epidemiology, BiostatisticsColorectal cancer screeningUSMLE Step 3

A 58-year-old woman smoked 1 pack daily for 24 years and quit 8 years ago. She has no respiratory symptoms, prior cancer, or serious comorbidity limiting treatment. Chest radiography 2 years ago was normal. Which preventive strategy is most appropriate?

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Correct answer: A — Offer annual low-dose chest CT after shared decision-making about screening

The best answer is “Offer annual low-dose chest CT after shared decision-making about screening”. She is 50–80 years old, has at least 20 pack-years, and quit within 15 years, so she meets USPSTF criteria for annual low-dose CT. Screening continues until 15 years since quitting, age 80, or development of a condition that precludes curative treatment. Chest radiography and sputum cytology do not reduce lung-cancer mortality as screening substitutes.

Reference: USPSTF Recommendation: Lung Cancer Screening: https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/lung-cancer-screening