Which of the following causes iron deficiency anemia during pregnancy?
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A high protein, meat diet
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A vegetarian diet
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Iron deficiencies are limited to first-time pregnancies
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Consuming a single beer each day
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Anemia during pregnancy can cause, or has been associated with
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spontaneous abortion.
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high birth weight.
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overdue births.
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breast cancer.
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Malignant melanoma can metastasize to
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the lymph nodes only.
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the skin but not other organs.
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any organ.
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the skin and lymph nodes only.
CORRECT ANSWERS:
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One of the limitations of screening tests is
a. guidelines are often changed and updated.
“However, it is important to remember the following points when broad screening guidelines are used for a heterogeneous population… Screening guidelines are always being changed and updated.”
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Screening tests must be used with the understanding that
c. they are not diagnostic.
“However, it is important to remember the following points when broad screening guidelines are used for a heterogeneous population… A screening test is not a diagnostic test.”
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Adults should be screened for alcohol misuse if they
d. engage in risky drinking behavior.
“Screen for alcohol misuse and provide brief behavioral counseling interventions to persons engaged in risky or hazardous drinking.”
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Breast cancer is
b. the second most common cancer in women.
“Breast cancer is the most common cancer in women, excluding skin cancer."
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Breast cancer screening may include
d. mammography and genetic testing.
“There is convincing evidence that using mammography to screen for breast cancer reduces overall mortality from breast cancer… Genetic testing for breast cancer is recommended for women whose family history may be associated with an increased risk for potentially harmful breast cancer mutations.”
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Screening for cervical cancer
a. significantly decreases mortality from the disease.
“Cervical cancer screening decreases the incidence and mortality of cervical cancer.”
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Colorectal cancer screening can be done using
b. fecal occult blood testing and colonoscopy.
“The USPSTF recommendations for colorectal cancer screening are highlighted below. Age 50-75: Screen with high sensitivity fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy…. Screening intervals: Annual screening with high-sensitivity fecal occult blood testing;…”
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Screening adolescents age 12-18 for depression is recommended if
c. follow-up care and support is available.
“The USPSTF advises that adolescents age 12-18 should be screened for depression when there are resources in place for diagnosis, treatment, and follow-up.”
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True or False: Almost 30 percent of people who have diabetes go undiagnosed.
a. True
“Approximately 27.8% of people who have diabetes are undiagnosed,…”
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The American Diabetes Association recommends screening for diabetes using
b. fasting plasma glucose.
“The American Diabetes Association recommends screening with fasting plasma glucose (FPG),…”
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People who have diabetes should periodically be screened for
c. cardiovascular disease.
“Asymptomatic patients should not be screened for cardiovascular disease but cardiovascular risk factors should be assessed annually, at least. These risk factors include dyslipidemia, hypertension, family history of premature cardiovascular disease, presence of albuminuria, and smoking.”
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Screening for Hepatitis B is recommended for
b. IV drug users and men who have sex with men.
“The CDC recommends screening the following groups for Hepatitis B … Injection-drug users… Men who have sex with men.”
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Screening for Hepatitis C is recommended for
d. anyone born between 1945 and 1965.
“The USPSTF recommendations for hepatitis screening are highlighted here… Persons at high risk for infection and adults born between 1945 and 1965 should be screened.”
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Screening for HIV is recommended for
a. anyone having unprotected anal or vaginal intercourse.
“Younger adolescents and adults considered to be at increased risk include:… Anyone having unprotected vaginal or anal intercourse.”
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True or False: The USPSTF recommends that all adults should be screened for hypertension.
a. True
“The USPSTF screening recommendations,… include the following… All adults be screened for hypertension.”
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Intimate partner violence
b. includes physical, sexual, psychological harm.
“Intimate partner violence is defined by the CDC as physical violence, sexual violence, stalking and psychological aggression (including coercive acts) by a current or former intimate partner.”
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Screening for obesity is done by measuring
d. body mass index.
“Screening for obesity is recommended and the USPSTF advises that adults age 18 and older be screened by using body mass index (BMI)…”
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Osteoporosis is very common in
c. elderly white females.
“Risk factors for osteoporosis are outlined below as:… Asian or white race… Female > 65 years of age.”
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All pregnant women should be screened for
b. bacteriuria.
“The USPSTF recommends that all pregnant women be screened for asymptomatic bacteriuria.”
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True or False: The benefits of prostate cancer screening far outweigh the risks.
b. False
“Screening for prostate cancer by measuring prostate-specific antigen (PSA) and digital rectal examination can reduce the mortality rate prostate cancer but this reduction is very small and does not outweigh the risks.”
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All newborns should be screened for
c. phenylketonuria.
“Screening for PKU is mandated in all 50 states, and infants should be screened at or near seven days of age.”
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All pregnant women should be screened for
a. gonorrhea.
“The USPSTRF recommends that all pregnant women be screened for syphilis at the first prenatal visit…”
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All newborns should be screened for
a. sickle cell disease.
“The USPSTF recommends that all newborn infants be screened for sickle cell disease…”
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True or False: Screening infants for hearing impairment is mandatory.
a. True
“Hearing testing for newborns is mandatory in all 50 states.”
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All newborns should be screened for
d. congenital hypothyroidism.
“Screening newborns for congenital hypothyroidism is mandatory in all 50 states and in the District of Columbia.”
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Which of the following is the leading cause of preventable deaths in the United States?
c. Tobacco
“Tobacco use is the leading cause of preventable death in the United States.”
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Which of the following is NOT true regarding cigarette smoking in the United State?
c. Less than one million adults live with a smoking-related disease.
“More than 16 million Americans live with a smoking-related disease.”
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Heath effects of second-hand smoke include
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sudden infant death syndrome (SIDS).
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ear infections.
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pneumonia.
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All of the above [Correct Answer]
“Heath effects of second-hand smoke: ear infections, pneumonia, sudden infant death syndrome (SIDS).”
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Which of the following is one of the three drugs that are approved by the Food and Administration (FDA) for assisting patients with smoking cessation?
c. Varenicline
“There are three drugs that are approved by the Food and Administration (FDA) for assisting patients with smoking cessation:… and varenicline.”
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The USPSTF and the American Cancer Society recommends asymptomatic adults, aged 55 to 80 years, have annual screening with low dose computed tomography if they have a 30 pack-year history of smoking and currently smoke or have quit smoking
a. within the past 15 years.
“The USPSTF and the American Cancer Society recommends that asymptomatic adults aged 55 to 80 years who have a 30 pack-year history of smoking and currently smoke or have quit smoking within the past 15 years should have annual screening with low dose computed tomography.”
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True or False: Second-hand smoke is smoke that is produced from burning tobacco or smoke that has been exhaled by someone using a cigarette and although second-hand smoke may be dangerous, there are safe levels of second-hand smoke.
b. False
“Second-hand smoke is smoke that is produced from burning tobacco or smoke that has been exhaled by someone using a cigarette and there is no safe level of second-hand smoke.”
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The USPSTF advises or states that
a. clinicians should be aware of, and alert to the signs and symptoms of illicit drug use.
“’The USPSTF advises that clinicians should be aware of, and alert to the signs and symptoms of illicit drug use but that’… the evidence is insufficient to determine the benefits and harms of screening for illicit drug use.”
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Risk factors for non-melanoma and melanoma skin cancer include
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indoor tanning.
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a family history of melanoma.
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the use of psoralen.
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All of the above [Correct Answer]
“Risk factors for non-melanoma and melanoma skin cancer include (but are not limited to: 1) Caucasian ethnicity, 2) exposure to sunlight, 3) indoor tanning, 4) immunosuppression, 5) fair skin, 6) family history of melanoma, 7) atypical nevi, 8) advanced age, 9) psoralen, and 10) UVA light therapy.”
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The American Dental Association in 2010 published guidelines about oral cancer screening stated or recommended
d. oral inspection and tactile palpation as screening tools.
“The American Dental Association in 2010 published guidelines… noted that oral inspection and tactile palpation were the recommended screening tools. These guidelines also noted that the use of devices that rely on auto-fluorescence or tissue reflectance to detect oral cancers do not appear to be superior for this purpose when compared to conventional visual inspection and tactile palpation.”
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Congenital syphilis that is untreated can cause
c. early infant death.
“Syphilis can be transmitted from an infected mother to an unborn child: this is called congenital syphilis. Congenital syphilis that is untreated can cause early infant death, miscarriage, spontaneous abortion, still birth, late complications in the infant, and other serious sequelae.”
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Which of the following is a modifiable risk factor for coronary heart disease?
a. diabetes.
“Modifiable risk factors include cigarette smoking, diabetes, diet, elevated serum lipids and cholesterol, hypertension, obesity, and sedentary life style. Non-modifiable risk factors are age, gender, and family history of coronary heart disease.”
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True or False: The four question CAGE screening test for alcohol use, which is familiar to many healthcare professionals, is NOT recommended as a screening tool for alcohol use as it is not highly sensitive or specific.
a. True
“The CAGE test is not recommended as a screening tool for alcohol use as it is not highly sensitive or specific.”
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The USPSTF recommendations for cervical cancer screening for women aged 30-65 is
b. screen three years with a Pap smear and HPV testing.
“The USPSTF recommendations for cervical cancer screening are highlighted below… Women aged 30-65: screen every three years with a Pap smear or a Pap smear and HPV testing.”
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The USPSTF recommendations for cervical cancer screening for women over the age of 65 is
c. to not screen.
“The USPSTF recommendations for cervical cancer screening are highlighted below... Women older than age 65 who have had adequate prior screening and are not high risk: Do not screen.”
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The USPSTF states that screening for cervical cancer earlier than age 21 years
a. leads to more harms than benefits.
“The USPSTF recommendations for cervical cancer screening are highlighted below... Screening earlier than age 21 years, regardless of sexual history, leads to more harms than benefits.”
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True or False: The USPSTF recommends routine screening for skin cancer.
b. False
“The USPSTF does not recommend routine screening for skin cancer…”
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The diagnosis of hypertension cannot be confirmed until an elevated blood pressure is present
d. on several occasions.
“The diagnosis of hypertension cannot be confirmed until an elevated blood pressure is present on several occasions. Blood pressure can be measured in a physician’s office, by using ambulatory blood pressure monitoring, or using home blood pressure monitoring.”
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Blood pressure measurement is an important predictor of cardiovascular complications in people with
a. type 2 diabetes mellitus.
“Patients who are at risk for, or who have diabetes, should be screened for hypertension and blood pressure should be measured at every routine visit. A systolic blood pressure of ≤ 140 mm Hg or a blood pressure of < 140/90 m Hg is desirable. These levels have been associated with a reduction in CVD, nephropathy, and stroke in patients who have diabetes.”
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People who have sickle cell disease have hemoglobin S and when oxygen binds to _______________, red blood cells form an abnormal shape (the sickle shape).
d. hemoglobin S
“People who have sickle cell disease have hemoglobin S and when oxygen binds to hemoglobin S…”
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Basal cell carcinoma and squamous cell carcinoma are the two
b. non-melanoma skin cancers.
“Basal cell carcinoma and squamous cell carcinoma are the two non-melanoma skin cancers.”
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True or False: Because of the increased use of sunscreens, incidences of malignant melanoma, and deaths from this cancer, have been decreasing for years.
b. False
“Malignant melanoma can metastasize to any organ (most often the skin and lymph nodes) and the incidence of malignant melanoma and deaths from this cancer have been increasing for years.”
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The USPSTF recommends that __________ asymptomatic pregnant women be screened for iron deficiency anemia by measuring hematocrit and hemoglobin levels.
c. all
“The USPSTF recommends that all asymptomatic pregnant women be screened for iron deficiency anemia by measuring hematocrit and hemoglobin levels.”
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Which of the following causes iron deficiency anemia during pregnancy?
b. A vegetarian diet
“Causes of iron deficiency anemia during pregnancy include poor intake, poor nutrition, gastrointestinal disease, vegetarian diet, medications that interfere with iron absorption, and multiple pregnancies.”
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Anemia during pregnancy can cause, or has been associated with
a. spontaneous abortion.
“Anemia during pregnancy can cause, or has been associated with increased maternal mortality, premature birth, spontaneous abortion, fetal death, low birth weight, and in utero abnormalities.”
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Malignant melanoma can metastasize to
c. any organ.
“Malignant melanoma can metastasize to any organ (most often the skin and lymph nodes) and the incidence of malignant melanoma and deaths from this cancer have been increasing for years.”
References Section
The References below include published works and in-text citations of published works that are intended as helpful material for your further reading.
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http://www.uspreventiveservicestaskforce.org/. This link is to the USPSTF main page. [Keyword searches, i.e., “Alcohol Misuse,” will link you to the relevant discussion and screening recommendations].
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Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 154927, NSDUH Series H-50). http://www.samhsa.gov/data/. Accessed July 30, 2016.
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Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 alcohol use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015; 72(8):757-766.
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Saltz R, Screening for unhealthy use of alcohol and other drugs in primary care. UpToDate. August 7, 2015. http://www.uptodate.com/contents/screening-for-unhealthy-use-of-alcohol-and-other-drugs-in-primary-care. Accessed August 14, 2016.
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Agency for Healthcare Research and Quality. U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services 2014. http://www.uspreventiveservicestaskforce.org/. Accessed August 14, 2016. [This link is to the USPSTF main page. Keyword searches, i.e., “Alcohol Misuse,” will link you to the relevant discussion and screening recommendations].
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Fujii H, et al., The Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) is more useful than pre-existing laboratory tests for predicting hazardous drinking: a cross-sectional study. BMC Public Health. 2016 May 10;16:379. doi: 10.1186/s12889-016-3053-6.
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Timko C, Kong C, Vittorio L, Cucciare MA. Screening and brief intervention for unhealthy substance use in patients with chronic medical conditions: a systematic review. J Clin Nurs. 2016 May 3. doi: 10.1111/jocn.13244. [Epub ahead of print].
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McNeely J, Strauss SM, Wright S, et al. Test-retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients. J Subst Abuse Treat. 2014;47(1):93-101.
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Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993;88:791-804.
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Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789-1795.
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Centers for Disease Control and Prevention. Breast cancer statistics. March 23, 2016. http://www.cdc.gov/cancer/breast/statistics/index.htm. Accessed August 15, 2016.
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American Cancer Society. American Cancer Society Guidelines for the Early Detection of Cancer. March 11, 2015. http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer. Accessed August 15, 2015.
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Centers for Disease Control and Prevention. Cervical cancer statistics. June 20, 2016. http://www.cdc.gov/cancer/cervical/statistics/index.htm. Accessed August 15, 2016.
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Feldman S, Goodman A. Screening for cervical cancer. UpToDate. April 4, 2016.
https://www.uptodate.com/contents/screening-for-cervical-cancer?source=machineLearning&search=pap+screening+guidelines&selectedTitle=1~148§ionRank=1&anchor=H321. Accessed August 15, 2016.
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McNamara M, Walsh J. Women’s health issues. In: Papadakis MA, McPhee SJ, Rabow MW, eds. Current Medical Diagnosis & Treatment 2016, 55th ed. New York, NY: McGraw-Hill; 2016. Online edition. Accessed August 15, 2016 from www.UCHC.edu.
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The American Congress of Obstetricians and Gynecologists. Cervical cancer screening. http://www.acog.org/. Accessed August 15, 2016.
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Centers for Disease Control and Prevention. Colorectal cancer statistics. June 20, 2016. http://www.cdc.gov/cancer/colorectal/statistics/index.htm. Accessed August 15, 2016.
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Doubeni C. Tests for screening for colorectal cancer: Stool tests, radiologic imaging and endoscopy. UpToDate. July 29, 2016. http://www.uptodate.com/contents/tests-for-screening-for-colorectal-cancer-stool-tests-radiologic-imaging-and-endoscopy. Accessed August 15, 2016.
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Doubeni C. Screening for colorectal cancer: Strategies in patients at average risk. UpToDate. August 1, 2016. https://www.uptodate.com/contents/screening-for-colorectal-cancer-strategies-in-patients-at-average-risk?source=preview&search=colorectal+cancer+screening+guidelines&language=en-US&anchor=H710325447&selectedTitle=1~103. Accessed August 15, 2016.
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Reumkens A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanu S. Post-colonoscopy complications: A systematic review, time trends, and meta-analysis of population-based studies. Am J Gastroenterol. 2016;111(8):1092-1101.
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Cappell MS Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: endoscopic findings, therapy, and complications. Med Clin North Am. 2002;86(6):1253-1288.
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Holme Ø, Bretthauer M, Fretheim A, Odgaard-Jensen J, Hoff G. Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals. Cochrane Database Syst Rev. 2013 Oct 1;(9):CD009259. doi: 10.1002/14651858.CD009259.pub2.
http://www.heart.org/HEARTORG/Conditions/Heart-Health-Screenings_UCM_428687_Article.jsp.
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American Cancer Society. Oral cavity cancer and oropharyngeal cancer. http://www.cancer.org/cancer/oralcavityandoropharyngealcancer/detailedguide/oral-cavity-and-oropharyngeal-cancer-key-statistics. Accessed August 16, 2016.
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