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Cancer Risk Assessment

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Cancer Risk Assessment

Personal Profile

Question 01

Your age group

Under 30 30 – 39 40 – 49 50 – 59 60 and above

Question 02

Sex

Female Male

Lifestyle Factors

Question 03

Tobacco use — smoking or chewing

Never used tobacco Past user (stopped) Current smokeless tobacco (gutkha / khaini / pan with tobacco) Current smoker Both smoking and smokeless tobacco

Question 04 — Shown based on Q3

Smoking exposure in pack-years

1 pack-year = smoking 1 pack (20 cigarettes) per day for 1 year. Half a pack per day for 10 years = 5 pack-years.

Less than 10 pack-years 10 – 19 pack-years 20 – 29 pack-years 30 or more pack-years

Question 05

Alcohol intake

None or occasional — 0 to 2 drinks per week Moderate — 3 to 7 drinks per week Heavy — more than 7 drinks per week

Question 06

Body weight and physical activity

Healthy weight and active most days Overweight or low physical activity Obese and mostly inactive

Question 07

Diet pattern — most weeks

Mostly home-cooked food with good fruits and vegetables Mixed diet with irregular fruits and vegetables High processed or packaged foods, or frequent processed meat

Medical History

Question 08

Family history of cancer — parents, siblings, or children

No close family history of cancer One close relative diagnosed at age 50 or above One close relative diagnosed below age 50 Two or more close relatives with cancer (any age)

Question 09

Have you ever had cancer or a pre-cancer condition?

Examples: previous cancer, dysplasia, colon polyps requiring follow-up, cervical pre-cancer treatment.

No Yes

Question 10

High-risk medical conditions — select all that apply

Chronic hepatitis B or C, or cirrhosis Long-term inflammatory bowel disease or repeated colon polyps Long-term immune suppression (transplant medicines or prolonged steroids) HPV-related disease or persistent abnormal Pap history None of these

Question 11

Occupational or environmental exposure — 10 or more years

None or do not know Regular exposure to chemicals, dust, or fumes (industrial, paint, solvents, pesticides) Known higher-risk exposure — asbestos or radiation at work

Question 12 — For females aged 30+

Cervical screening status

Up to date — screened within the last 3 to 5 years Not done or overdue

Question 13 — For females aged 40+

Breast screening status

Up to date — clinical exam or mammography as advised Not done or overdue

Question 14 — For people aged 50+

Colon screening status

Screened as advised — stool test or colon examination Never screened or overdue

Current Symptoms

Question 15

Warning symptoms right now — select all that apply

New lump in the breast, neck, or anywhere on the body Bleeding in stool or urine, or abnormal vaginal bleeding Persistent cough or hoarseness lasting more than 3 weeks Difficulty swallowing or a non-healing mouth ulcer for more than 2 weeks Unexplained weight loss or persistent fatigue Change in bowel habits lasting more than 3 weeks None of these

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Centres & Contact Info

Onco - Life Cancer Centre, Satara

02162-350063 | 7769004343 | 7030362222

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Onco - Lifecare Cancer Centre, Chiplun

7378958000 | 9404240762

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TGH - Onco Life Cancer Centre, Talegaon

8128124067 | 8128123067

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Onco - Lifecare Cancer Centre, Wagholi

8128124067 | 8128123067

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