75.2 📚 國考版（醫師國考 / PGY OSCE）

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75.2.0.1 📌 Cram Sheet

75.2.0.1.1 🔥 高 yield 10

1. 5 大 cancer screening (USPSTF 2024):
   • CRC 45-75
   • Breast 40-74
   • Cervix 21-65
   • Lung 50-80 + smoker
   • Prostate 55-69 SDM
2. Smoking 1/3 cancer
3. Obesity 13 cancer types
4. HPV vaccine ≤ 45 yo
5. HBV 預防 HCC
6. H. pylori 預防 gastric/MALT
7. Tamoxifen for high-risk breast
8. Aspirin USPSTF 2022 撤回 CRC routine
9. LDCT > CXR for lung
10. Taiwan 國健署 4 大癌: CRC, breast, cervical, oral

75.2.0.1.2 🔢 必背

項目	數字
CRC USPSTF age	45-75
Breast USPSTF 2024	40-74 q2y
Cervical	21-65
Lung pack-year	≥ 20
Lung age	50-80
Quit < years	15
Prostate SDM age	55-69
HPV vaccine age	≤ 45 yo (FDA 2018)
HBV vaccine	newborn + adults at risk

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75.2.0.2 ⭐ 高 yield

75.2.0.2.1 Cancer-Causing Infections

Infection	Cancer
HPV 16/18	Cervical, oropharyngeal, anal
HBV / HCV	HCC
H. pylori	Gastric (intestinal) + MALT
EBV	Hodgkin, NHL, NPC, gastric
HHV-8	Kaposi sarcoma
HTLV-1	Adult T-cell leukemia/lymphoma
Schistosoma haematobium	Bladder SCC
Liver flukes (Opisthorchis)	Cholangiocarcinoma

75.2.0.2.2 USPSTF Grades

• A/B: 推薦
• C: shared decision
• D: 不推薦
• I: 不足 evidence

75.2.0.2.3 Taiwan 國健署 4 大癌

1. 大腸癌 (FIT 50-74 yo)
2. 乳癌 (mammography 45-69 yo, 高 risk 40-44)
3. 子宮頸癌 (Pap 30+ yo)
4. 口腔癌 (oral exam 30+ yo + 嚼檳榔/吸菸)

75.2.0.2.4 Chemoprevention

病	藥	對象
Breast	Tamoxifen / raloxifene	High-risk women
Breast (post-menop)	AI	High-risk
CRC	Aspirin	USPSTF 2022 撤回
Prostate	Finasteride	爭議
HCC	Antiviral HBV/HCV	Reduce risk

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75.2.0.3 🎯 自我檢測

1. CRC USPSTF age 2021? → 45-75
2. Breast USPSTF 2024? → 40-74 q2y
3. Cervical age range? → 21-65
4. Lung LDCT criteria? → 50-80 + ≥ 20 pack-year + quit < 15 yr
5. Prostate SDM age? → 55-69
6. HPV vaccine age cap? → 45 yo
7. HBV cancer? → HCC
8. H. pylori cancer 2? → Gastric + MALT
9. HHV-8 cancer? → Kaposi
10. Schistosoma cancer? → Bladder SCC
11. Smoking cancer %? → 1/3
12. Tamoxifen menopausal? → Pre + post
13. Raloxifene? → Post only
14. Taiwan 4 大癌? → CRC, breast, cervical, oral

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