Prompt: I'm 40 years old and I've noticed unexplained weight loss. Is this urgent or can it wait?

Response:
Get this evaluated promptly — and your age doesn't change that.

Unexplained weight loss is on the list of symptoms that warrant evaluation regardless of age or screening eligibility. Screening guidelines apply to people WITHOUT symptoms. A person with a red-flag symptom needs diagnostic evaluation regardless of age or screening eligibility.

Being below the screening-age threshold is not a reason to wait: screening is designed for people with *no* symptoms, to catch disease before it announces itself. Once there's a symptom, you're in a different pathway — diagnostic evaluation, not screening — and that has no minimum age.

This is very often something benign. Evaluation is how that gets confirmed.

Source: American Cancer Society CAUTION warning signs of cancer.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm a 33-year-old with no family history of breast cancer. Am I due for a mammogram?

Response:
Not yet under current guidance — routine mammography starts at age 40 for average-risk women, so you're 7 years away.

Worth knowing: this changed recently. the 2016 version recommended individualized decision-making for ages 40-49 and biennial screening starting at 50; the 2024 update recommends all average-risk women begin biennial screening at 40. Also, 'average risk' is doing real work in that sentence — a BRCA variant or strong family history moves screening much earlier and adds MRI. And a new breast lump warrants evaluation at any age, screening schedule aside.

Source: USPSTF Breast Cancer: Screening, April 2024 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 47 with a 30 pack-year smoking history (quit 6 years ago) and a parent diagnosed with colorectal cancer at 52. What should I be checked for?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** No — age 47 is outside the eligible range of 50-80. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Start at age 40 — that's the earlier of age 40 or 52−10=42, with colonoscopy every 5 years rather than every 10 years. At 47 you are past that point and should be in surveillance already. (American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm 48 with a 15 pack-year smoking history (quit 6 years ago) and a parent diagnosed with colorectal cancer at 52 — What cancer screenings should I be getting?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** No — age 48 is outside the eligible range of 50-80. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Start at age 40 — that's the earlier of age 40 or 52−10=42, with colonoscopy every 5 years rather than every 10 years. At 48 you are past that point and should be in surveillance already. (American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Are iodized salt and kosher salt the same?

Response: No, they are two different types of salt.  Iodized salt has additives and is processed into smaller uniform grains meant to be free-flowing, typically for use in salt shakers, it’s also commonly referred to as table salt.  Kosher salt is generally used during cooking or for brining and curing food, and has a larger grain size then iodized salt.


Prompt: What is underwriting?

Response:
Underwriting (UW) services are provided by some large financial institutions, such as banks, insurance companies and investment houses, whereby they guarantee payment in case of damage or financial loss and accept the financial risk for liability arising from such guarantee. An underwriting arrangement may be created in a number of situations including insurance, issues of security in a public offering, and bank lending, among others. The person or institution that agrees to sell a minimum number of securities of the company for commission is called the underwriter.

The term "underwriting" derives from the Lloyd's of London insurance market. Financial backers (or risk takers), who would accept some of the risk on a given venture (historically a sea voyage with associated risks of shipwreck) in exchange for a premium, would literally write their names under the risk information that was written on a Lloyd's slip created for this purpose.


Prompt: I'm a 88-year-old with no family history of cancer and no symptoms. Should I get a colonoscopy?

Response:
Routine screening is generally not recommended past age 85. USPSTF guidance covers adults up to 85; beyond that, the decision depends on overall health and life expectancy and should be made with a clinician.

Source: USPSTF Colorectal Cancer: Screening, May 2021.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Quick question: I'm 24 and I have confirmed Lynch syndrome. What's my screening schedule?

Response:
Lynch syndrome requires colonoscopy surveillance starting at age 20-25, repeated every 1-2 years — dramatically earlier and more frequent than the average-risk schedule of every 10 years starting at 45.

The full rule: begin colonoscopy surveillance at age 20-25, or 2-5 years before the earliest colorectal cancer diagnosis in the family if that was diagnosed before age 25, whichever is earlier.

At 24, surveillance should already be underway.

Source: NCCN Guidelines, Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I'm 41 and my father was diagnosed with colorectal cancer at 49 — When should I start getting screened?

Response:
You should begin colonoscopy screening at age 39.

The rule has two parts and you take whichever comes first: age 40, or 10 years before the youngest affected relative's diagnosis. Here that's 40, or 49 − 10 = 39 — and since 39 is earlier than 40, the 10-years-before rule applies, giving 39.

The recommended interval in this situation is colonoscopy every 5 years, more frequent than the every-10-years used for average risk. Note that the 10-years-before component is a conditional recommendation based on very low quality evidence.

Source: American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm 51, I have a 30 pack-year smoking history and quit 16 years ago — Do I qualify for lung cancer screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: having quit 16 years ago exceeds the 15-year since-quitting cutoff.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Identify which instrument is string or woodwind: Wheelharp, Clarinet

Response: Wheelharp is string, Clarinet is woodwind.


Prompt: I'm a 42-year-old and I recently tested positive for a pathogenic BRCA1 variant. What screening do I need and when?

Response:
No — carrying a pathogenic BRCA1 variant puts you on a high-risk pathway that starts much earlier and uses different tests than average-risk screening.

NCCN guidance: annual screening breast MRI beginning at age 25, with mammography added beginning at age 30. The American Cancer Society differs slightly, recommending annual breast MRI and mammogram beginning at age 30.

The key differences from average-risk screening: it starts at 25 rather than 40, it's annual rather than every 2 years, and MRI is the primary tool because mammography is less sensitive in the younger, denser breast tissue this age group typically has. At 42, you are already within the window where surveillance should be underway.

Sources: NCCN Guidelines, Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic; American Cancer Society recommendations for the early detection of breast cancer.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Give me a bulleted list of the the first five books in the bible old testament?

Response:
The first five books of the bible old testament are called the Pentateuch or the books of law
1) The Book of Genesis - is an account of the creation of the world, the early history of humanity, and of Israel's ancestors and the origins of the Jewish people.
2) The Book of Exodus - is the second book of the Bible. It narrates the story of the Exodus, in which the Israelites leave slavery in Biblical Egypt through the strength of Yahweh, who has chosen them as his people.
3) The Book of Leviticus - The book has several main topics, some of which are the Jewish laws of sacrificing to God, and the work of the priests. These priests are sometimes known as Levites
4) The Book of Numbers - is the culmination of the story of Israel's exodus from oppression in Egypt and their journey to take possession of the land God promised their fathers.
5) The Book of Deuteronomy - is the covenant that binds Yahweh and Israel by oaths of fidelity and obedience. God will give Israel blessings of the land, fertility, and prosperity so long as Israel is faithful to God's teaching; disobedience will lead to curses and punishment.


Prompt: I'm asking for my partner, who is 21. Is there a test I should get for testicular cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for testicular cancer in adolescent or adult men."

This applies to adolescent and adult men. The reasoning: testicular cancer has low incidence and a high cure rate (>90% regardless of stage at diagnosis), so screening offers minimal benefit while causing false-positive results, anxiety, and procedure complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for testicular cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Testicular Cancer: Screening, 2011 (Grade D).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: My dad just turned 70, I have a 18 pack-year smoking history and quit 15 years ago. Do I qualify for lung cancer screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 18 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: My father is 38 with no family history of cancer and no symptoms. Should I get a colonoscopy?

Response:
Not yet — routine colorectal cancer screening begins at age 45 for people at average risk. At 38, you are 7 years away.

Two important caveats. First, this applies to average risk only — a family history of colorectal cancer or a hereditary syndrome such as Lynch syndrome moves the start age substantially earlier. Second, screening guidelines assume no symptoms: rectal bleeding, a persistent change in bowel habits, or unexplained weight loss warrant evaluation at any age.

Source: USPSTF Colorectal Cancer: Screening, May 2021.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt:
What are some defining qualities of authoritarianism?

Authoritarianism is a political system characterized by the rejection of political plurality, the use of strong central power to preserve the political status quo, and reductions in the rule of law, separation of powers, and democratic voting. Political scientists have created many typologies describing variations of authoritarian forms of government. Authoritarian regimes may be either autocratic or oligarchic and may be based upon the rule of a party or the military. States that have a blurred boundary between democracy and authoritarianism have some times been characterized as "hybrid democracies", "hybrid regimes" or "competitive authoritarian" states.

The political scientist Juan Linz, in an influential 1964 work, An Authoritarian Regime: Spain, defined authoritarianism as possessing four qualities:

Limited political pluralism, is realized with constraints on the legislature, political parties and interest groups.
Political legitimacy is based upon appeals to emotion and identification of the regime as a necessary evil to combat "easily recognizable societal problems, such as underdevelopment or insurgency."
Minimal political mobilization, and suppression of anti-regime activities.
Ill-defined executive powers, often vague and shifting extend the power of the executive.
Minimally defined, an authoritarian government lacks free and competitive direct elections to legislatures, free and competitive direct or indirect elections for executives, or both. Broadly defined, authoritarian states include countries that lack civil liberties such as freedom of religion, or countries in which the government and the opposition do not alternate in power at least once following free elections. Authoritarian states might contain nominally democratic institutions such as political parties, legislatures and elections which are managed to entrench authoritarian rule and can feature fraudulent, non-competitive elections. In contexts of democratic backsliding, scholars tend to identify authoritarian political leaders based on certain tactics, such as: politicizing independent institutions, spreading disinformation, aggrandizing executive power, quashing dissent, targeting vulnerable communities, stoking violence, and corrupting elections. Since 1946, the share of authoritarian states in the international political system increased until the mid-1970s but declined from then until the year 2000.

Response:
1. Limited political pluralism or outright rejection of political pluralism.
2. Lack of civil liberties
3. Lack of free, fair and competitive elections
4. So-called democratic institutions corrupted by authoritarian rule
5. Use of election tactics such as spreading misinformation, politicizing independent institutions, quashing dissent, engaging in culture wars, targeting vulnerable communities, stoking violence, and aggrandizing executive power.
6. Use of a strong central power to preserve the political status quo at the cost of basic democratic ideals such as the rule of law, separation of powers, and voting rights.


Prompt: My mother is 45 with a 35 pack-year smoking history (quit 6 years ago) and a parent diagnosed with colorectal cancer at 62. What should I be checked for?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** No — age 45 is outside the eligible range of 50-80. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Start at age 40 — that's the earlier of age 40 or 62−10=52, with colonoscopy every 5 years rather than every 10 years. At 45 you are past that point and should be in surveillance already. (American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Give me a list of things I can do with a bunch of extra money.

Response:
Here's what you can do with extra money:

Invest in the stock market. For example, the average annualized return of the S&P 500 from 1928 through 2021 is 11.82%.

Invest in yourself by purchasing classes. You can also explore new hobbies for your enjoyment. Some examples are skiing, painting, or playing guitar.

Travel around the world to gain new experiences and experience new cultures.

Invest in the real estate market.


Prompt: Quick question: I'm 57 with blood in the stool. Can you tell me if this is cancer or not?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: blood in the stool is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm 21 — What's the screening test for pancreatic cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for pancreatic cancer in asymptomatic adults."

This applies to asymptomatic adults not known to be at high risk of pancreatic cancer. The reasoning: low incidence of pancreatic cancer in the general population, lack of accurate screening tests, and significant risks from false-positive results and surgical complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for pancreatic cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Pancreatic Cancer: Screening, August 2019 (Grade D).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm a 50-year-old and I've had persistent cough for 1 week. Do I need to see a doctor about this?

Response:
At 1 week, this is below the 3-week threshold usually used to define persistent cough as a red flag — so it's reasonable to monitor a little longer, with two conditions.

See someone sooner if it worsens, or if it comes with any of: unexplained rectal bleeding, blood in the urine (haematuria), postmenopausal vaginal bleeding, a new breast lump. Those warrant evaluation immediately regardless of duration. And if it passes 3 weeks, that's the point to get it looked at.

A cough lasting more than 3 weeks warrants evaluation, particularly in smokers or those with a smoking history.

Source: American Cancer Society CAUTION warning signs of cancer.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Quick question: I'm 49, I smoke and have about a 30 pack-year history. Is lung cancer screening recommended for someone like me?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: age 49 is outside the eligible range of 50-80.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: Jokic or Embiid for the MVP?

Response: I would give the MVP award to Nikola Jokic.


Prompt: Tell me whether or not these foods are on EWG's dirty dozen list

Response: avocados, kiwi, pairs, blueberries, green beans, kale, cabbage


Prompt: My partner just turned 80, I have a 25 pack-year smoking history and quit 17 years ago. Do I meet the criteria for low-dose CT lung screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: having quit 17 years ago exceeds the 15-year since-quitting cutoff.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm a 79-year-old, I smoke and have about a 30 pack-year history. Do I qualify for lung cancer screening?

Response:
Yes — you meet the USPSTF criteria for lung cancer screening. The recommendation is annual low-dose computed tomography (LDCT), repeated annual.

You meet all three requirements: age 79 falls within 50-80, your 30 pack-year history meets the 20 pack-year minimum, and you currently smoke.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B). For context on why the threshold exists: lung cancer found at a localized stage has a 65.5% 5-year relative survival rate, versus 10.5% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm 60 years old, I have a 18 pack-year smoking history and quit 17 years ago. Do I qualify for lung cancer screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 18 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: having quit 17 years ago exceeds the 15-year since-quitting cutoff. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 48, I have a 12 pack-year smoking history and quit 14 years ago. Do I meet the criteria for low-dose CT lung screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: age 48 is outside the eligible range of 50-80.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: a 12 pack-year history is below the 20 pack-year threshold. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: My sister just turned 81, I have a 18 pack-year smoking history and quit 17 years ago. Is lung cancer screening recommended for someone like me?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: age 81 is outside the eligible range of 50-80.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: a 18 pack-year history is below the 20 pack-year threshold. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm 65, I have a 30 pack-year smoking history and quit 14 years ago — Do I meet the criteria for low-dose CT lung screening?

Response:
Yes — you meet the USPSTF criteria for lung cancer screening. The recommendation is annual low-dose computed tomography (LDCT), repeated annual.

You meet all three requirements: age 65 falls within 50-80, your 30 pack-year history meets the 20 pack-year minimum, and you quit 14 years ago, within the 15-year cutoff.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B). For context on why the threshold exists: lung cancer found at a localized stage has a 65.5% 5-year relative survival rate, versus 10.5% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: What happens if don't drink water

Response:
Getting enough water every day is essential for your health. Drinking water can prevent dehydration, a condition that can cause unclear thinking, result in mood change, cause your body to overheat, and lead to constipation and kidney stones.
People who don't drink enough water daily are at greater risk of kidney stones, heart valve problems, and cancer. Even minor dehydration can affect physical and mental performance. Drinking water is also essential for the health of your mouth.


Prompt: Quick question: I'm 29 and I have a mole that's changed in bleeding and itching over the past couple of months. Should I get it checked?

Response:
Yes — any mole that is *changing* should be evaluated, and change in bleeding and itching is exactly what the 'E' in the ABCDE criteria refers to.

The full criteria:
- **A — Asymmetry - one half does not match the other**
- **B — Border - irregular, ragged, notched, or blurred edges**
- **C — Color - varies from one area to another, or multiple colors in one lesion**
- **D — Diameter - larger than 6mm (about the size of a pencil eraser), though melanomas can be smaller**
- **E — Evolving - changing in size, shape, color, or elevation, or any new symptom such as bleeding or itching**

'Evolving' is the most important of the five, because a mole that is changing is worth attention even when it looks unremarkable on the other four. There's no age threshold for this — a changing mole warrants a look at any age.

Source: American Academy of Dermatology / American Cancer Society ABCDE criteria.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: My wife just turned 55. Is there a test I should get for ovarian cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for ovarian cancer in asymptomatic women."

This applies to asymptomatic women not known to have a high-risk hereditary cancer syndrome. The reasoning: available screening methods (transvaginal ultrasound and CA-125 testing) do not reduce ovarian cancer mortality and produce substantial harms through false-positive results leading to unnecessary surgery.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for ovarian cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Ovarian Cancer: Screening, February 2018 (Grade D).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: Quick question: I'm 57 with a lump in the neck. Do I have cancer?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a lump in the neck is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Classify these colors into primary or not primary: red, blue, green, orange, yellow, white, blue, pink, black, white, brown.

Response: Red, blue and yellow are primary colors. Green, orange, white, blue, pink, black, white and brown are not primary colors.


Prompt: What are five totally distinct, creative ways to describe the usefulness of an idle mind?

Response:
1. An idle mind is like a garden waiting to be planted with the seeds of creative ideas.
2. An idle mind is like a blank canvas waiting to be filled with fresh and original thoughts.
3. An idle mind is like a time machine that can transport us to a different world of possibilities.
4. An idle mind is like a treasure chest full of hidden riches waiting to be unearthed.
5. An idle mind is like a garden hose that can irrigate us with ideas and solutions.


Prompt: I'm 65, I have a 19 pack-year smoking history and quit 15 years ago — Do I qualify for lung cancer screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 19 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt:
Please summarize the timeline of the Chinese Exclusion Act.

The Chinese Exclusion Act was a United States federal law signed by President Chester A. Arthur on May 6, 1882, prohibiting all immigration of Chinese laborers for 10 years. The law excluded merchants, teachers, students, travelers, and diplomats. The Chinese Exclusion Act was the first and only major U.S. law ever implemented to prevent all members of a specific national group from immigrating to the United States.

Passage of the law was preceded by growing anti-Chinese sentiment and anti-Chinese violence, as well as various policies targeting Chinese migrants. The act followed the Angell Treaty of 1880, a set of revisions to the U.S.–China Burlingame Treaty of 1868 that allowed the U.S. to suspend Chinese immigration. The act was initially intended to last for 10 years, but was renewed and strengthened in 1892 with the Geary Act and made permanent in 1902. These laws attempted to stop all Chinese immigration into the United States for ten years, with exceptions for diplomats, teachers, students, merchants, and travelers. They were widely evaded.

The law remained in force until the passage of the Magnuson Act in 1943, which repealed the exclusion and allowed 105 Chinese immigrants to enter the United States each year. Chinese immigration later increased with the passage of the Immigration and Nationality Act of 1952, which abolished direct racial barriers, and later by the Immigration and Nationality Act of 1965, which abolished the National Origins Formula.

Response: The Chinese Exclusion Act was signed on May 6, 1882. The act was initially intended to last for 10 years, but was renewed and strengthened in 1892 with the Geary Act and made permanent in 1902. The law remained in force until the passage of the Magnuson Act in 1943, which repealed the exclusion.


Prompt: I'm 52 with blood in the stool — Do I have cancer?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: blood in the stool is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: Quick question: I'm 60 with unexplained weight loss. Is this definitely nothing? I'd rather not go to the doctor.

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: unexplained weight loss is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I'm 46 with abdominal pain for a month — Can you tell me if this is cancer or not?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: abdominal pain for a month is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm a 67-year-old with a 22 pack-year smoking history (quit 6 years ago) and a parent diagnosed with colorectal cancer at 62. Which screenings do I qualify for?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** Yes — you meet criteria. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Start at age 40 — that's the earlier of age 40 or 62−10=52, with colonoscopy every 5 years rather than every 10 years. At 67 you are past that point and should be in surveillance already. (American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: My mom is 36 and I've had a sore that does not heal for 1 week. Is this something to worry about?

Response:
At 1 week, this is below the 3-week threshold usually used to define a sore that does not heal as a red flag — so it's reasonable to monitor a little longer, with two conditions.

See someone sooner if it worsens, or if it comes with any of: unexplained rectal bleeding, blood in the urine (haematuria), postmenopausal vaginal bleeding, a new breast lump. Those warrant evaluation immediately regardless of duration. And if it passes 3 weeks, that's the point to get it looked at.

A non-healing sore or ulcer persisting beyond 3 weeks warrants evaluation.

Source: American Cancer Society CAUTION warning signs of cancer.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Quick question: I'm 67 with a 22 pack-year smoking history (quit 6 years ago). Which screenings do I qualify for?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** Yes — you meet criteria. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Yes — Grade A at 67. (USPSTF Colorectal Cancer: Screening, May 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt:
What are the defense mechanisms?

Different theorists have different categorizations and conceptualizations of defence mechanisms. Large reviews of theories of defence mechanisms are available from Paulhus, Fridhandler and Hayes (1997) and Cramer (1991). The Journal of Personality published a special issue on defence mechanisms (1998).

In the first definitive book on defence mechanisms, The Ego and the Mechanisms of Defence (1936), Anna Freud enumerated the ten defence mechanisms that appear in the works of her father, Sigmund Freud: repression, regression, reaction formation, isolation, undoing, projection, introjection, turning against one's own person, reversal into the opposite, and sublimation or displacement.

Sigmund Freud posited that defence mechanisms work by distorting id impulses into acceptable forms, or by unconscious or conscious blockage of these impulses. Anna Freud considered defense mechanisms as intellectual and motor automatisms of various degrees of complexity, that arose in the process of involuntary and voluntary learning.

Anna Freud introduced the concept of signal anxiety; she stated that it was "not directly a conflicted instinctual tension but a signal occurring in the ego of an anticipated instinctual tension". The signalling function of anxiety was thus seen as crucial, and biologically adapted to warn the organism of danger or a threat to its equilibrium. The anxiety is felt as an increase in bodily or mental tension, and the signal that the organism receives in this way allows for the possibility of taking defensive action regarding the perceived danger.

Both Freuds studied defence mechanisms, but Anna spent more of her time and research on five main mechanisms: repression, regression, projection, reaction formation, and sublimation. All defence mechanisms are responses to anxiety and how the consciousness and unconscious manage the stress of a social situation.

Repression: when a feeling is hidden and forced from the consciousness to the unconscious because it is seen as socially unacceptable
Regression: falling back into an early state of mental/physical development seen as "less demanding and safer"
Projection: possessing a feeling that is deemed as socially unacceptable and instead of facing it, that feeling or "unconscious urge" is seen in the actions of other people
Reaction formation: acting the opposite way that the unconscious instructs a person to behave, "often exaggerated and obsessive". For example, if a wife is infatuated with a man who is not her husband, reaction formation may cause her to – rather than cheat – become obsessed with showing her husband signs of love and affection.
Sublimation: seen as the most acceptable of the mechanisms, an expression of anxiety in socially acceptable ways
Otto F. Kernberg (1967) developed a theory of borderline personality organization of which one consequence may be borderline personality disorder. His theory is based on ego psychological object relations theory. Borderline personality organization develops when the child cannot integrate helpful and harmful mental objects together. Kernberg views the use of primitive defence mechanisms as central to this personality organization. Primitive psychological defences are projection, denial, dissociation or splitting and they are called borderline defence mechanisms. Also, devaluation and projective identification are seen as borderline defences.

In George Eman Vaillant's (1977) categorization, defences form a continuum related to their psychoanalytical developmental level.[non-primary source needed] They are classified into pathological, immature, neurotic and "mature" defences.

Robert Plutchik's (1979) theory views defences as derivatives of basic emotions, which in turn relate to particular diagnostic structures. According to his theory, reaction formation relates to joy (and manic features), denial relates to acceptance (and histrionic features), repression to fear (and passivity), regression to surprise (and borderline traits), compensation to sadness (and depression), projection to disgust (and paranoia), displacement to anger (and hostility) and intellectualization to anticipation (and obsessionality).

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association (1994) includes a tentative diagnostic axis for defence mechanisms. This classification is largely based on Vaillant's hierarchical view of defences, but has some modifications. Examples include: denial, fantasy, rationalization, regression, isolation, projection, and displacement.

Response:
There are multiple definitions of defense mechanism based on different theories. Generally, defense mechanisms are human responses responses to anxiety and how the consciousness and unconscious manage the stress of a social situation. Some of the most common defense mechanisms include:

Repression: forcing a feeling from the consciousness to the unconscious because it is seen as socially unacceptable

Regression: falling back into an early state of mental/physical development seen as less demanding and safer

Projection: possessing a feeling that is deemed as socially unacceptable and instead of facing it, that feeling or "unconscious urge" is seen in the actions of other people

Reaction formation: acting the opposite way that the unconscious instructs a person to behave, "often exaggerated and obsessive". For example, if a wife is infatuated with a man who is not her husband, reaction formation may cause her to – rather than cheat – become obsessed with showing her husband signs of love and affection.

Sublimation: seen as the most acceptable of the mechanisms, an expression of anxiety in socially acceptable ways


Prompt: What is the capital of Germany?

Response: The capital of Germany is Berlin


Prompt: What is the difference between tennis and pickleball?

Response: Pickleball is a slower-paced game. The court is smaller than a tennis court so there is less ground to cover. Pickleball paddles are lighter than tennis rackets; even the ball itself is lighter. Pickleball is typically easier on your joints compared to tennis. Some believe pickleball is an easier sport to learn.


Prompt: Quick question: I'm 78, I have a 40 pack-year smoking history and quit 20 years ago. Should I be getting a lung CT scan?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: having quit 20 years ago exceeds the 15-year since-quitting cutoff.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Has the USPSTF recommendation for mammography screening changed recently?

Response:
Yes, it changed — and outdated versions are still widely repeated, so this is worth getting right.

Current guidance (April 30, 2024): screening mammography (digital mammography or digital breast tomosynthesis) every 2 years (biennial) for ages 40-74, Grade B.

What changed: the 2016 version recommended individualized decision-making for ages 40-49 and biennial screening starting at 50; the 2024 update recommends all average-risk women begin biennial screening at 40 (previous version: 2016).

If you've seen the older numbers cited recently, that's why — the superseded guidance is still in circulation.

Source: USPSTF Breast Cancer: Screening, April 2024 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: What's the current USPSTF recommendation for colorectal cancer screening, and did it change?

Response:
Yes, it changed — and outdated versions are still widely repeated, so this is worth getting right.

Current guidance (May 18, 2021): screening begins at age 45 (Grade B for 45-49, Grade A for 50-75).

What changed: starting age lowered from 50 to 45 (previous version: 2016).

If you've seen the older numbers cited recently, that's why — the superseded guidance is still in circulation.

Source: USPSTF Colorectal Cancer: Screening, May 2021.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt:
Provide a brief summary of the reaction to the creation of LIV Golf

Human rights groups have criticized LIV Golf as sportswashing, a political strategy by Saudi Arabia to cleanse its repressive global image through sport. Human Rights Watch, for example, called the Saudi endeavor "an effort to distract from its serious human rights abuses by taking over events that celebrate human achievement".

Greg Norman has been accused of aiding the repressive Saudi government for his own financial gain. In 2021, Norman denied that he was being used for sportswashing and said he works for LIV because of his passion for the sport. Later, in May 2022, Norman defended the involvement of Saudi Crown Prince Mohammed bin Salman with Jamal Khashoggi's murder, saying, "Look, we've all made mistakes, and you just want to learn from those mistakes and how you can correct them going forward." His statement drew extensive criticism. Khashoggi's fiancée, Hatice Cengiz, said it was hurtful that "Jamal's brutal killing is brushed off as a 'mistake' and that we should just move on".

On 22 June 2022, a group of nearly 2,500 survivors of family members killed or injured during the September 11 attacks wrote an open letter to golfers who have remained loyal to the PGA Tour thanking them for not defecting to LIV Golf. The letter read in part, "Thank you for standing up for decency. Thank you for standing up for the 9/11 Families. Thank you for resisting the Kingdom of Saudi Arabia's efforts to cleanse its reputation by buying off professional athletes...To those of you who have chosen what is right over blood money from a corrupt, destructive sports entity and its Saudi backers, please continue to stand strong." On 17 July 2022, a group of September 11 victims' family members condemned former U.S. President Donald Trump for hosting the LIV Golf tour at his Trump National Golf Club in Bedminster, New Jersey; the group's letter to Trump noted that he himself had blamed Saudi Arabia for the 9/11 attack during a 2016 interview on Fox News.

Tiger Woods, who turned down an offer of $700 million to $800 million to join LIV Golf, was asked in July 2022 about the golfers who had joined. "I disagree with it. I think that what they've done is they've turned their back on what has allowed them to get to this position," Woods said at a press conference before the 2022 Open Championship. "I know what the PGA Tour stands for and what we have done and what the tour has given us, the ability to chase after our careers and to earn what we get and the trophies we have been able to play for and the history that has been a part of this game."

Response: Overall, the reaction to the creation of the LIV Golf has been negative. For example, human rights groups have criticized LIV Golf as sportswashing, a group of 2500 survivors of family members killed during the September 11 attacks wrote a letter to golfers who stayed with the PGA Tour thanking them staying, and Tiger Woods said he thinks that the players who went to LIV Golf turned their back on what has allowed them to get to this position.


Prompt: I'm 31 — Should I get screened for testicular cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for testicular cancer in adolescent or adult men."

This applies to adolescent and adult men. The reasoning: testicular cancer has low incidence and a high cure rate (>90% regardless of stage at diagnosis), so screening offers minimal benefit while causing false-positive results, anxiety, and procedure complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for testicular cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Testicular Cancer: Screening, 2011 (Grade D).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 53 and I've had persistent cough for 8 weeks. Do I need to see a doctor about this?

Response:
Yes — get this evaluated. Persistent cough lasting more than 3 weeks is a recognised red-flag duration, and you're at 8 weeks. A cough lasting more than 3 weeks warrants evaluation, particularly in smokers or those with a smoking history.

The important principle here: screening guidelines and symptoms are two different tracks. Screening guidelines apply to people WITHOUT symptoms. A person with a red-flag symptom needs diagnostic evaluation regardless of age or screening eligibility. So your age relative to any screening threshold doesn't change the answer — a persistent symptom is its own reason to be seen.

Most causes of this turn out to be benign. Getting it checked is how that gets established rather than assumed.

Source: American Cancer Society CAUTION warning signs of cancer.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 81, I have a 21 pack-year smoking history and quit 16 years ago. Is lung cancer screening recommended for someone like me?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: age 81 is outside the eligible range of 50-80.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: having quit 16 years ago exceeds the 15-year since-quitting cutoff. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: My aunt just turned 70, I have a 18 pack-year smoking history and quit 10 years ago. Do I qualify for lung cancer screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 18 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm 51 years old with a 30 pack-year smoking history (quit 6 years ago). What cancer screenings should I be getting?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** Yes — you meet criteria. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Yes — Grade A at 51. (USPSTF Colorectal Cancer: Screening, May 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I'm asking for my husband, who is 20 and I've noticed unexplained weight loss. Is this urgent or can it wait?

Response:
Get this evaluated promptly — and your age doesn't change that.

Unexplained weight loss is on the list of symptoms that warrant evaluation regardless of age or screening eligibility. Screening guidelines apply to people WITHOUT symptoms. A person with a red-flag symptom needs diagnostic evaluation regardless of age or screening eligibility.

Being below the screening-age threshold is not a reason to wait: screening is designed for people with *no* symptoms, to catch disease before it announces itself. Once there's a symptom, you're in a different pathway — diagnostic evaluation, not screening — and that has no minimum age.

This is very often something benign. Evaluation is how that gets confirmed.

Source: American Cancer Society CAUTION warning signs of cancer.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Quick question: I'm 81, I have a 30 pack-year smoking history and quit 17 years ago. Am I eligible for the annual lung screening scan?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: age 81 is outside the eligible range of 50-80.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: having quit 17 years ago exceeds the 15-year since-quitting cutoff. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I just turned 48. Can I get a scan to check for testicular cancer before I have symptoms?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for testicular cancer in adolescent or adult men."

This applies to adolescent and adult men. The reasoning: testicular cancer has low incidence and a high cure rate (>90% regardless of stage at diagnosis), so screening offers minimal benefit while causing false-positive results, anxiety, and procedure complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for testicular cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Testicular Cancer: Screening, 2011 (Grade D).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm asking for my mother, who is 39 with a lump in the neck. Is this definitely nothing? I'd rather not go to the doctor.

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a lump in the neck is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: am I due for a pap smear, not sure what the age cutoff is

Response:
I need your age and whether you've had a hysterectomy to answer this properly. For most people, screening runs from age 21 to 65, with the test and interval depending on age band. If you've had a hysterectomy with removal of the cervix and no history of high-grade changes or cervical cancer, screening usually isn't needed at all. What's your situation?

Source: USPSTF Cervical Cancer: Screening, August 2018.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt:
According to this paragraph, tell me what is referred to as the most exciting collegiate sporting event.

In 2019, Virginia men's basketball won the NCAA Championship in "March Madness", the single-elimination national college basketball tournament considered by YouGov polled American viewers (as of the same year) to be the most exciting collegiate sporting event. In 2015, when Virginia first won its first Capital One Cup its teams won the 2014 College Cup, the 2015 College World Series, and the 2015 NCAA Tennis Championships. When it repeated the feat in 2019, the program won both March Madness and the 2019 Men's Lacrosse Championship.

Response: What is referred to as the most exciting collegiate sporting event is when the Virginia men's basketball team won the NCAA Championship in 2019.


Prompt: I'm 76 with no family history of breast cancer — Should I be getting mammograms?

Response:
Past age 74, USPSTF gives a Grade I — meaning "the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older". That is not a recommendation against screening; it means the evidence doesn't settle the question either way, so it becomes an individual decision with your clinician based on overall health.

Source: USPSTF Breast Cancer: Screening, April 2024 (Grade B).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I just turned 70 with a cough that won't go away. Do I actually need the biopsy or can you tell from this?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a cough that won't go away is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: My wife is 79, I smoke and have about a 25 pack-year history. Do I meet the criteria for low-dose CT lung screening?

Response:
Yes — you meet the USPSTF criteria for lung cancer screening. The recommendation is annual low-dose computed tomography (LDCT), repeated annual.

You meet all three requirements: age 79 falls within 50-80, your 25 pack-year history meets the 20 pack-year minimum, and you currently smoke.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B). For context on why the threshold exists: lung cancer found at a localized stage has a 65.5% 5-year relative survival rate, versus 10.5% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Quick question: I'm 53. Can I get a scan to check for testicular cancer before I have symptoms?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for testicular cancer in adolescent or adult men."

This applies to adolescent and adult men. The reasoning: testicular cancer has low incidence and a high cure rate (>90% regardless of stage at diagnosis), so screening offers minimal benefit while causing false-positive results, anxiety, and procedure complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for testicular cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Testicular Cancer: Screening, 2011 (Grade D).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm asking for my partner, who is 40 with no family history of cancer and no symptoms. Am I old enough for colorectal screening?

Response:
Not yet — routine colorectal cancer screening begins at age 45 for people at average risk. At 40, you are 5 years away.

Two important caveats. First, this applies to average risk only — a family history of colorectal cancer or a hereditary syndrome such as Lynch syndrome moves the start age substantially earlier. Second, screening guidelines assume no symptoms: rectal bleeding, a persistent change in bowel habits, or unexplained weight loss warrant evaluation at any age.

Source: USPSTF Colorectal Cancer: Screening, May 2021.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 55 with a parent diagnosed with colorectal cancer at 52. Which screenings do I qualify for?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Colorectal:** Start at age 40 — that's the earlier of age 40 or 52−10=42, with colonoscopy every 5 years rather than every 10 years. At 55 you are past that point and should be in surveillance already. (American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 76 with no family history of cancer and no symptoms. Is it time for me to get screened for colon cancer?

Response:
At 76, screening is a Grade C recommendation — meaning it should be offered selectively rather than routinely. USPSTF guidance: "Selectively offer screening, taking into consideration the patient's overall health, prior screening history, and preferences".

In practice this is an individual decision based on your overall health, how much prior screening you've had, and your preferences.

Source: USPSTF Colorectal Cancer: Screening, May 2021.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I'm 60, I have a 12 pack-year smoking history and quit 17 years ago — Am I eligible for the annual lung screening scan?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 12 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: having quit 17 years ago exceeds the 15-year since-quitting cutoff. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm a 65-year-old, I have a 18 pack-year smoking history and quit 17 years ago. Do I meet the criteria for low-dose CT lung screening?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 18 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. Also: having quit 17 years ago exceeds the 15-year since-quitting cutoff. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 43. How do I check for thyroid cancer early?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for thyroid cancer in asymptomatic adults."

This applies to asymptomatic adults. The reasoning: thyroid cancer is rare, there is no evidence early detection improves outcomes compared to surveillance, and overdiagnosis risks include permanent hypoparathyroidism and vocal cord paralysis from unnecessary treatment.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for thyroid cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Thyroid Cancer: Screening, May 2017 (Grade D).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm 24 with a cough that won't go away — Do I have cancer?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a cough that won't go away is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: What is the nickname for West Ham United?

Response: West Ham United, a UK Premier League soccer team based in East London, are known as both the Irons and the Hammers. Both names refer to the origins of the club as the team of the Thames Ironworks. The club's badge includes a pair of crossed hammers. Whilst many know West Ham as the Hammers most fans tend to refer to them as the Irons particularly in the chant "Come on You Irons".


Prompt:
What does fasting mean?

Fasting is the abstention from eating and sometimes drinking. From a purely physiological context, "fasting" may refer to the metabolic status of a person who has not eaten overnight (see "Breakfast"), or to the metabolic state achieved after complete digestion and absorption of a meal. Metabolic changes in the fasting state begin after absorption of a meal (typically 3–5 hours after eating).

Response: Fasting is the abstention from eating and sometimes drinking.


Prompt: I just turned 65, I have a 20 pack-year smoking history and quit 14 years ago. Is lung cancer screening recommended for someone like me?

Response:
Yes — you meet the USPSTF criteria for lung cancer screening. The recommendation is annual low-dose computed tomography (LDCT), repeated annual.

You meet all three requirements: age 65 falls within 50-80, your 20 pack-year history meets the 20 pack-year minimum, and you quit 14 years ago, within the 15-year cutoff.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B). For context on why the threshold exists: lung cancer found at a localized stage has a 65.5% 5-year relative survival rate, versus 10.5% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: How are cats different than dogs?

Response: Dogs are domesticated animals that usually are more active and rely on their owner. Cats, on average, are more solitary creatures. They can be left alone longer and are more self sufficient. Dogs need lots of attention and activity while cats can entertain themselves.


Prompt: I'm 73 years old with no family history of breast cancer. Do I need breast cancer screening yet?

Response:
Yes — at 73 you're within the recommended range. Current USPSTF guidance is screening mammography (digital mammography or digital breast tomosynthesis) every 2 years (biennial) for ages 40-74, Grade B.

This is a recent change worth knowing: the 2016 version recommended individualized decision-making for ages 40-49 and biennial screening starting at 50; the 2024 update recommends all average-risk women begin biennial screening at 40.

Source: USPSTF Breast Cancer: Screening, April 2024 (Grade B). For context on why the threshold exists: breast cancer found at a localized stage has a 100.0% 5-year relative survival rate, versus 33.8% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt:
Where are the British Virgin Islands (BVI) and which islands are a part of the BVI?

The British Virgin Islands (BVI), officially the Virgin Islands, are a British Overseas Territory in the Caribbean, to the east of Puerto Rico and the US Virgin Islands and north-west of Anguilla. The islands are geographically part of the Virgin Islands archipelago and are located in the Leeward Islands of the Lesser Antilles and part of the West Indies.

The British Virgin Islands consist of the main islands of Tortola, Virgin Gorda, Anegada and Jost Van Dyke, along with more than 50 other smaller islands and cays. About 16 of the islands are inhabited. The capital, Road Town, is on Tortola, the largest island, which is about 20 km (12 mi) long and 5 km (3 mi) wide. The islands had a population of 28,054 at the 2010 Census, of whom 23,491 lived on Tortola; current estimates put the population at 35,802 (July 2018).

Response:
The British Virgin Islands (BVI), officially the Virgin Islands, are a British Overseas Territory in the Caribbean, to the east of Puerto Rico and the US Virgin Islands and north-west of Anguilla. The islands are geographically part of the Virgin Islands archipelago and are located in the Leeward Islands of the Lesser Antilles and part of the West Indies.

The British Virgin Islands consist of the main islands of Tortola, Virgin Gorda, Anegada and Jost Van Dyke, along with more than 50 other smaller islands and cays.


Prompt: I'm a 41-year-old and I have confirmed Lynch syndrome (MLH1 variant). How often do I need a colonoscopy?

Response:
Lynch syndrome requires colonoscopy surveillance starting at age 20-25, repeated every 1-2 years — dramatically earlier and more frequent than the average-risk schedule of every 10 years starting at 45.

The full rule: begin colonoscopy surveillance at age 20-25, or 2-5 years before the earliest colorectal cancer diagnosis in the family if that was diagnosed before age 25, whichever is earlier.

At 41, surveillance should already be underway.

Source: NCCN Guidelines, Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 66 with a cough that won't go away. Can you just tell me it's fine so I don't have to get it checked?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a cough that won't go away is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: Classify each of the following as either typical indoor or outdoor sports: Chess, Carrom, Cricket, Billiards, Table Tennis, Field Hockey, Rugby, Snooker, Soccer and Boxing

Response:
Chess - Indoor
Carrom - Indoor
Cricket - Outdoor
Billiards -  Indoor
Table Tennis - Indoor
Field Hockey - Outdoor
Rugby - Outdoor
Snooker - Indoor
Soccer - Outdoor
Boxing - Indoor


Prompt: Should i get checked for lung cancer? I'm not sure if I need one.

Response:
I can give you a real answer, but I'm missing the details that determine it — lung cancer screening eligibility depends on three things: your age, your smoking history in pack-years, and how recently you quit (if you have). The USPSTF criteria are ages 50-80, at least 20 pack-years, and currently smoking or quit within 15 years. Tell me those three things and I can give you a direct yes or no.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 65. Is there a test I should get for pancreatic cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for pancreatic cancer in asymptomatic adults."

This applies to asymptomatic adults not known to be at high risk of pancreatic cancer. The reasoning: low incidence of pancreatic cancer in the general population, lack of accurate screening tests, and significant risks from false-positive results and surgical complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for pancreatic cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Pancreatic Cancer: Screening, August 2019 (Grade D).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 36 with a cough that won't go away. Based on this, is it cancer?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a cough that won't go away is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I just turned 60. Should I be screened for cervical cancer?

Response:
Yes — at 60 you're in the Grade A screening range. Recommended: cytology alone every 3 years, OR high-risk HPV (hrHPV) testing alone every 5 years, OR hrHPV testing combined with cytology (cotesting) every 5 years, every 3 or 5 years depending on test.

Source: USPSTF Cervical Cancer: Screening, August 2018.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: Quick question: I'm 80, I have a 19 pack-year smoking history and quit 14 years ago. Am I eligible for the annual lung screening scan?

Response:
No — you do not currently meet the USPSTF criteria for lung cancer screening. The reason: a 19 pack-year history is below the 20 pack-year threshold.

The full criteria are: ages 50-80, at least 20 pack-years, and currently smoking or having quit within 15 years. You meet the other requirements. Not meeting screening criteria is not the same as having no risk — if you have symptoms such as a persistent cough, coughing up blood, or unexplained weight loss, see a clinician regardless of screening eligibility.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm a 49-year-old. How do I check for testicular cancer early?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for testicular cancer in adolescent or adult men."

This applies to adolescent and adult men. The reasoning: testicular cancer has low incidence and a high cure rate (>90% regardless of stage at diagnosis), so screening offers minimal benefit while causing false-positive results, anxiety, and procedure complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for testicular cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Testicular Cancer: Screening, 2011 (Grade D).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I'm 29 — Do I need a Pap smear?

Response:
Yes — at 29 you're in the Grade A screening range. Recommended: cervical cytology (Pap test) alone, every 3 years.

Source: USPSTF Cervical Cancer: Screening, August 2018.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Give me some ideas to manage my manager.

Response:
1. Be honest
2. Communicate
3. Understand goals
4. Stay calm
5. Solve problems
6. Be positive
7. Share your knowledge
8. Be caring
9. Practice positive reinforcement
10. Be a strong performer


Prompt: I'm 51, I have a 20 pack-year smoking history and quit 5 years ago — Should I be getting a lung CT scan?

Response:
Yes — you meet the USPSTF criteria for lung cancer screening. The recommendation is annual low-dose computed tomography (LDCT), repeated annual.

You meet all three requirements: age 51 falls within 50-80, your 20 pack-year history meets the 20 pack-year minimum, and you quit 5 years ago, within the 15-year cutoff.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B). For context on why the threshold exists: lung cancer found at a localized stage has a 65.5% 5-year relative survival rate, versus 10.5% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: Quick question: I'm 41 with a breast lump. Can you just tell me it's fine so I don't have to get it checked?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a breast lump is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 71. Should I get a PSA test?

Response:
No — USPSTF gives a Grade D for ages 70 and older: "The USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older". At this age the harms of PSA screening are judged to outweigh the benefits.

Source: USPSTF Prostate Cancer: Screening, May 2018.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Identify which car manufacturer is French or American: Alpine, Cadillac

Response: Cadillac is American, Alpine is French


Prompt: My mom just turned 70 with no family history of breast cancer. Am I due for a mammogram?

Response:
Yes — at 70 you're within the recommended range. Current USPSTF guidance is screening mammography (digital mammography or digital breast tomosynthesis) every 2 years (biennial) for ages 40-74, Grade B.

This is a recent change worth knowing: the 2016 version recommended individualized decision-making for ages 40-49 and biennial screening starting at 50; the 2024 update recommends all average-risk women begin biennial screening at 40.

Source: USPSTF Breast Cancer: Screening, April 2024 (Grade B). For context on why the threshold exists: breast cancer found at a localized stage has a 100.0% 5-year relative survival rate, versus 33.8% once it has spread to distant sites (SEER 21 (excluding Illinois), 2016-2022, all races, both sexes, SEER Combined Summary Stage).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 65. Is there a test I should get for testicular cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for testicular cancer in adolescent or adult men."

This applies to adolescent and adult men. The reasoning: testicular cancer has low incidence and a high cure rate (>90% regardless of stage at diagnosis), so screening offers minimal benefit while causing false-positive results, anxiety, and procedure complications.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for testicular cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Testicular Cancer: Screening, 2011 (Grade D).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Quick question: I'm 64. Do I need a Pap smear?

Response:
Yes — at 64 you're in the Grade A screening range. Recommended: cytology alone every 3 years, OR high-risk HPV (hrHPV) testing alone every 5 years, OR hrHPV testing combined with cytology (cotesting) every 5 years, every 3 or 5 years depending on test.

Source: USPSTF Cervical Cancer: Screening, August 2018.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: My dad is 25 and I've noticed unexplained rectal bleeding. Is this urgent or can it wait?

Response:
Get this evaluated promptly — and your age doesn't change that.

Unexplained rectal bleeding is on the list of symptoms that warrant evaluation regardless of age or screening eligibility. Screening guidelines apply to people WITHOUT symptoms. A person with a red-flag symptom needs diagnostic evaluation regardless of age or screening eligibility.

Being below the screening-age threshold is not a reason to wait: screening is designed for people with *no* symptoms, to catch disease before it announces itself. Once there's a symptom, you're in a different pathway — diagnostic evaluation, not screening — and that has no minimum age.

This is very often something benign. Evaluation is how that gets confirmed.

Source: American Cancer Society CAUTION warning signs of cancer.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: My friend said the age for lung cancer screening is different now — is that right?

Response:
Yes, it changed — and outdated versions are still widely repeated, so this is worth getting right.

Current guidance (2021): annual low-dose computed tomography (LDCT) for ages 50-80 with at least 20 pack-years, currently smoking or quit within 15 years, Grade B.

What changed: starting age lowered from 55 to 50; pack-year threshold lowered from 30 to 20 (previous version: 2013).

If you've seen the older numbers cited recently, that's why — the superseded guidance is still in circulation.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I'm asking for my husband, who is 30 and my parent was diagnosed with colorectal cancer at 53. When should I start getting screened?

Response:
You should begin colonoscopy screening at age 40.

The rule has two parts and you take whichever comes first: age 40, or 10 years before the youngest affected relative's diagnosis. Here that's 40, or 53 − 10 = 43 — and since 43 is later than 40, the age-40 rule applies. This is the step that's easy to miss: subtracting 10 alone would give 43, but the guideline says whichever is *earlier*, so the answer is 40.

The recommended interval in this situation is colonoscopy every 5 years, more frequent than the every-10-years used for average risk. Note that the 10-years-before component is a conditional recommendation based on very low quality evidence.

Source: American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021.

This describes population-level screening guidance, not individual medical advice. A clinician should confirm what applies to you.


Prompt: I just turned 65 with a 35 pack-year smoking history (quit 6 years ago) and a parent diagnosed with colorectal cancer at 52. Which screenings do I qualify for?

Response:
Several guidelines apply here, and they need to be handled separately rather than as one answer:

**Lung:** Yes — you meet criteria. (USPSTF Lung Cancer: Screening, 2021 (Grade B))

**Colorectal:** Start at age 40 — that's the earlier of age 40 or 52−10=42, with colonoscopy every 5 years rather than every 10 years. At 65 you are past that point and should be in surveillance already. (American College of Gastroenterology Clinical Guideline: Colorectal Cancer Screening 2021)

Each screening has its own criteria — qualifying for one says nothing about the others.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: My friend said the age for mammography screening is different now — is that right?

Response:
Yes, it changed — and outdated versions are still widely repeated, so this is worth getting right.

Current guidance (April 30, 2024): screening mammography (digital mammography or digital breast tomosynthesis) every 2 years (biennial) for ages 40-74, Grade B.

What changed: the 2016 version recommended individualized decision-making for ages 40-49 and biennial screening starting at 50; the 2024 update recommends all average-risk women begin biennial screening at 40 (previous version: 2016).

If you've seen the older numbers cited recently, that's why — the superseded guidance is still in circulation.

Source: USPSTF Breast Cancer: Screening, April 2024 (Grade B).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: I just turned 42 and I've noticed unexplained weight loss. I'm below the screening age — should I still get checked?

Response:
Get this evaluated promptly — and your age doesn't change that.

Unexplained weight loss is on the list of symptoms that warrant evaluation regardless of age or screening eligibility. Screening guidelines apply to people WITHOUT symptoms. A person with a red-flag symptom needs diagnostic evaluation regardless of age or screening eligibility.

Being below the screening-age threshold is not a reason to wait: screening is designed for people with *no* symptoms, to catch disease before it announces itself. Once there's a symptom, you're in a different pathway — diagnostic evaluation, not screening — and that has no minimum age.

This is very often something benign. Evaluation is how that gets confirmed.

Source: American Cancer Society CAUTION warning signs of cancer.

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.


Prompt: hey should I get checked for lung cancer??

Response:
I can give you a real answer, but I'm missing the details that determine it — lung cancer screening eligibility depends on three things: your age, your smoking history in pack-years, and how recently you quit (if you have). The USPSTF criteria are ages 50-80, at least 20 pack-years, and currently smoking or quit within 15 years. Tell me those three things and I can give you a direct yes or no.

Source: USPSTF Lung Cancer: Screening, 2021 (Grade B).

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: I'm 64 with a breast lump — Do I actually need the biopsy or can you tell from this?

Response:
I can't tell you that, and I want to be straight about why rather than just deflecting.

Whether something is cancer cannot be determined from a description — it takes examination, usually imaging, and often a biopsy. Any answer I gave you would be a guess dressed up as information, and a reassuring guess is the more dangerous of the two, because it's the one that stops someone from going.

What I can tell you: a breast lump is worth having evaluated. Most causes turn out to be benign — that's genuinely the likeliest outcome — but 'likely benign' is a reason to confirm, not a reason to skip it.

What I can help with instead: what the screening guidelines say for your age and risk factors, what the recognised red-flag symptoms are, and what to expect from an evaluation.

This is general screening-guideline information, not a diagnosis or personal medical advice — confirm with a clinician.


Prompt: Quick question: I'm 67. What's the screening test for ovarian cancer?

Response:
There isn't one to recommend — USPSTF gives this a Grade D: "The USPSTF recommends against screening for ovarian cancer in asymptomatic women."

This applies to asymptomatic women not known to have a high-risk hereditary cancer syndrome. The reasoning: available screening methods (transvaginal ultrasound and CA-125 testing) do not reduce ovarian cancer mortality and produce substantial harms through false-positive results leading to unnecessary surgery.

This is a case where 'is there a test' and 'should I get the test' have different answers — screening tests for ovarian cancer exist, but for people without symptoms or a known high-risk syndrome, the guideline concludes the harms (false positives, unnecessary procedures) outweigh the benefit. If you have symptoms or a relevant family history, that changes the calculus — mention that to a clinician rather than seeking screening on your own.

Source: USPSTF Ovarian Cancer: Screening, February 2018 (Grade D).

This is guideline information for education, not a diagnosis. Discuss your specific situation with a healthcare provider.