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Mrs. Carson, an 80-year-old woman with stage 4 heart failure, asks about cancer screening. She had a colonoscopy at age 70 and a mammogram 2 years ago without significant findings. She asks if she should have cancer screening done today. The NP appreciates that Mrs. Carson should have:

a) A mammogram.
b) A colonoscopy.
c) A Pap test.
d) No cervical, breast or colorectal cancer screening done at this time

User Ketu
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1 Answer

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Final answer:

Mrs. Carson, an 80-year-old with stage 4 heart failure, should not undergo further cervical, breast, or colorectal cancer screenings due to her age and health status. Benefits of screening must be weighed against risks, and in her case, ongoing screening is less likely to be beneficial.

Step-by-step explanation:

Mrs. Carson, an 80-year-old woman with stage 4 heart failure, inquires about cancer screening. Considering her age and health status, the current recommendation would be d) No cervical, breast, or colorectal cancer screening done at this time. Cancer screening aims to detect cancers in asymptomatic individuals, but the benefits must be weighed against the potential risks, especially in elderly patients with other significant health issues.

For breast cancer, routine screening mammograms are recommended for women aged 50 and older, typically annually. Mrs. Carson's last mammogram was 2 years ago, and at her age, the balance of benefits vs. harms should be considered, likely skewing towards not screening given her stage 4 heart failure. Screening for cervical cancer, such as the Pap test, is generally discontinued after age 65 if the individual has had a history of normal results.

With colon cancer screening, a colonoscopy performed ten years prior might have sufficed, especially if she had no familial history or other risk factors. Health care providers may recommend less invasive methods for screening than a full colonoscopy in older age, especially for patients with serious comorbid conditions.

User Dave Martorana
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