SU9.1-3 | Surgical Investigations and Cancer Detection — Glossary

The stepwise progression from benign adenomatous polyp through dysplasia to invasive colorectal cancer; the basis of colorectal screening.

The NMC module on Attitude, Ethics and Communication that frames doctor-patient communication competencies.

A tumour marker raised in hepatocellular carcinoma and non-seminomatous germ-cell tumours.

The layer beneath an epithelium; its breach by malignant cells marks the change from in-situ to invasive carcinoma.

Communicating serious or unwelcome information (such as a cancer diagnosis) to a patient in a structured, empathic way.

A tumour marker associated with pancreatic and biliary cancers; can also rise with benign biliary obstruction, so it is not diagnostic on its own.

Symptoms that should prompt urgent cancer work-up: change in bowel/bladder habit, non-healing sore, unusual bleeding, a lump, dysphagia/indigestion, a changing mole, persistent cough/hoarseness.

Frankly malignant cells still confined above the basement membrane, unable to metastasise until they invade.

A chain of further tests and interventions triggered by an incidental or false-positive finding, often causing harm without clinical benefit.

A tumour marker used mainly to monitor treatment and detect recurrence in colorectal cancer; not specific and not a screening test.

The duty to keep a patient's information private and to disclose results to others only with consent or in the patient's interest.

Guiding a patient through the implications of a result and the next steps, including options, prognosis and support.

Examination of cells obtained by fine-needle aspiration; samples cells but not tissue architecture, so it is often a screening or first-line tissue test.

A protective reaction in which a patient rejects the news; managed by gentle restatement and time, not confrontation.

The period when cancer or its precursor is present and findable but the patient is still asymptomatic — the window screening exploits.

Disordered, atypical epithelial growth that is pre-malignant but not yet invasive cancer.

Prompt recognition and work-up of a person who already has early symptoms (warning signs) of cancer.

Recognising, acknowledging and responding to a patient's emotions, a central element of breaking bad news.

A negative test result in a person who does have the disease; a risk with insensitive tests, which cannot safely exclude disease.

A positive test result in a person who does not have the disease; common when a test is used in a low-prevalence population.

Rapid intra-operative histological examination of a specimen to guide decisions during surgery.

Examination of a tissue specimen (core or excision biopsy) that preserves architecture; the definitive standard for tissue diagnosis.

A patient's voluntary agreement to a course of action after being given and understanding the relevant information.

Cancer that has breached the basement membrane and can spread to regional nodes and distant organs.

Asking how much information the patient wishes to receive, and respecting their preference.

Apparent lengthening of survival caused only by earlier diagnosis, without any real change in the time of death.

X-ray imaging of the breast used to screen for early breast cancer.

The team of specialists who plan a patient's cancer care; serious results are counselled with onward MDT review in mind.

A meeting of all relevant cancer specialists who agree one coordinated, stage-based treatment plan for a patient.

The probability that a person with a negative test truly does not have the disease; it falls as pretest probability rises.

A patient's facial expression, posture, tears or silence, read during a consultation to gauge readiness and emotional state.

Detection by screening of indolent lesions that would never have harmed the patient, leading to unnecessary treatment.

Microscopic examination of cervical cells to detect pre-cancerous change (CIN); often combined with HPV DNA testing for cervical screening.

Communication that explores the patient's concerns and starting knowledge, follows their pace, and responds to their emotions and priorities.

Finding out what the patient already knows and believes before giving the news, so the explanation can be pitched appropriately.

The probability that a person with a positive test truly has the disease; it falls as pretest probability/prevalence falls.

The estimated likelihood of a disease BEFORE testing, derived from history and examination; it determines how much a test result can be trusted.

A prostate marker used in monitoring; its role in screening is limited by overdiagnosis and is not a routine general-population screen.

Testing an asymptomatic population to detect cancer or a treatable precursor before symptoms appear; a form of secondary prevention.

The proportion of people with the disease whom a test correctly identifies; a negative result on a highly sensitive test rules the disease out (SnNOut).

A competency level requiring the learner to demonstrate the skill (e.g. in simulation), not merely describe it.

The proportion of people without the disease whom a test correctly clears; a positive result on a highly specific test rules the disease in (SpPIn).

A six-step protocol for breaking bad news: Setting, Perception, Invitation, Knowledge, Emotions, and Strategy/Summary.

Defining the extent of a cancer — typically local tumour (T), regional nodes (N) and distant metastasis (M) — to plan treatment.

Asking the patient to restate, in their own words, what they have understood, to check and reinforce understanding.

A substance (e.g. CEA, CA 19-9, AFP, PSA, beta-hCG, CA-125) measured to support diagnosis, assess prognosis or monitor a known cancer — NOT a general-population screening test.

A brief preparatory statement ('I'm afraid the results are serious') given before bad news so it does not land abruptly.

The classic principles defining when population screening is worthwhile (important problem, latent stage, acceptable test, effective early treatment, cost-effectiveness).