Patient handout

Preventive cancer screening (adult)

PRODUCTION

1. Your condition

This handout is for preventive cancer screening (adult). Your care team identified this based on: routine preventive/wellness visit — age/sex-appropriate cancer screening due (uspstf 2021/2024).

Other reasons your team may use this plan: known hereditary cancer syndrome (lynch/brca/li-fraumeni/fap) requiring intensified surveillance (nccn 2024); overdue or never-screened patient identified at any encounter (uspstf 2021); follow-up after a positive screening result — apply ppv reasoning, route to diagnostic workup (uspstf 2021).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
low_dose_chest_ct_annual	LDCT annually, age 50-80, ≥20 pack-yr, current or quit <15 yr	imaging	annual	NLST (Aberle NEJM 2011 PMID 21714641): 20% lung-ca mortality RR + 6.7% all-cause RR vs CXR; 96.4% of positives false-positive over 3 rounds. NELSON (de Koning NEJM 2020 PMID 31995683): cumulative lung-ca death RR 0.76 men / 0.67 women at 10 yr with only 2.1% referral rate (volumetric Lung-RADS reduces FP).
plco_m2012_risk_model_eligibility	PLCOm2012 6-yr risk ≥1.3-1.7% threshold	n/a	at eligibility assessment	Expands LDCT to higher-yield candidates missed by categorical pack-year criteria (Tammemägi NEJM 2013).
smoking_cessation_pharmacotherapy_varenicline	Varenicline 1 mg BID × 12 wk (or NRT/bupropion) at every screen visit	PO	per cessation protocol	LDCT mortality benefit is conditional on cessation; integrate at each screen (USPSTF 2021).

Plan: Lung — LDCT (USPSTF 2021 Grade B PMID 33687470; NLST PMID 21714641; NELSON PMID 31995683)

3. When to call your provider

Contact your care team if any of the following happen:

Lung-RADS 4 → pulmonology/thoracic surgery; route onc.lung-cancer.core.v1 (ACR Lung-RADS 2022)
BI-RADS 4-5 → breast surgery/biopsy (ACR BI-RADS; USPSTF 2024)
Advanced adenoma or CRC on colonoscopy → GI/oncology (USMSTF 2020)
PSA elevated/rising → urology mpMRI/PI-RADS ± biopsy (AUA 2023)
LI-RADS 4-5 → hepatology/transplant oncology; route gi.hcc.core.v1 (AASLD 2023)
Hereditary syndrome confirmed → NCCN high-risk protocol + cascade testing (NCCN 2024)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Lung-RADS 4 (PPV >15%), BI-RADS 5 (PPV >95%), positive FIT/FIT-DNA, hrHPV 16/18+, LI-RADS 4-5 — post-test probability now high enough that the harm of NOT working up exceeds the harm of the diagnostic cascade
Confirmed Lynch (MLH1/MSH2/MSH6/PMS2 — CRC lifetime up to ~50-80%), BRCA1/2 (breast ~55-72% lifetime), Li-Fraumeni (TP53), or FAP (APC, near-100% CRC) — very high prior requiring earlier + more frequent multi-organ surveillance
LI-RADS 5 definite HCC on surveillance imaging in cirrhosis — surveillance has converted to diagnosis(life-threatening)

5. Follow-up

STOP-screening / survivorship logic (the deprescribing-equivalent): discontinue when life expectancy <10 yr, age exceeds the upper bound (mammo >74, CRC >85, cervical >65 with adequate prior negatives, PSA ≥70, LDCT after 15 yr quit or curative-surgery-ineligible, HCC if not transplant/treatment candidate). Patient education on false-positive rate (LDCT 96.4% over 3 rounds — NLST), overdiagnosis (mammography ~10-20%, prostate substantial), and the value of NOT screening when harm dominates (USPSTF 2021; ACS 2018)

6. Sources

Guideline: USPSTF 2018-2024 cancer screening recommendation statements + ACS 2018 colorectal + AASLD 2023 HCC + NCCN 2024 hereditary high-risk; 2025 WPSI cervical hrHPV-primary