Oncology MCQs (25 Questions): Criteria & Principles — MRCP Part 1

TL;DR

Oncology questions in MRCP Part 1 test core principles rather than niche chemotherapy facts. Expect screening criteria, tumour markers, paraneoplastic syndromes, oncological emergencies, and treatment complications. If you revise these themes systematically—and practise mixed MCQs—you can turn oncology into a reliable scoring area.

Why this matters for MRCP Part 1

Oncology is often underestimated because it appears “specialist.” In reality, MRCP Part 1 focuses on general medical reasoning applied to cancer, not oncologist-level detail. Questions are commonly integrated with respiratory medicine, gastroenterology, neurology, endocrinology, and haematology. Candidates lose marks by memorising drug names instead of understanding mechanisms, red flags, and first principles.

This article supports your preparation alongside the official MRCP Part 1 overview from Crack Medicine and is best used with active practice from a question bank and mock tests.

Scope of oncology in MRCP Part 1

Across roughly 20–30 questions, oncology appears in predictable patterns. The examiners are consistent year on year.

You are expected to know:

• Who should be screened, when, and why

• How cancers present clinically (often subtly)

• Which paraneoplastic syndromes point to specific tumours

• How to recognise oncological emergencies

• Common and serious adverse effects of cancer treatments

You are not expected to:

• Choose detailed chemotherapy regimens

• Recall dosing schedules

• Interpret complex staging systems

For exam alignment, the content broadly reflects the MRCP(UK) syllabushttps://www.mrcpuk.org/mrcpuk-examinations/mrcpuk-part-1

High-yield oncology principles (core revision list)

1. Screening follows strict criteria Screening is only effective when disease prevalence, test sensitivity, and benefit outweigh harm. Age cut-offs and risk groups are frequently tested.

2. Tumour markers are not screening tools Markers support diagnosis, staging, or monitoring—not population screening.

3. Paraneoplastic syndromes may precede diagnosis Many cancers present indirectly through metabolic, neurological, or dermatological effects.

4. Oncological emergencies are clinical diagnoses Early treatment often comes before definitive imaging or biopsy.

5. Weight loss + anaemia = malignancy until proven otherwise Especially in patients over 50.

6. Histology predicts behaviour Small-cell lung cancer spreads early; adenocarcinoma behaves differently.

7. Chemotherapy toxicity is predictable Exam questions focus on classic, serious adverse effects.

8. Radiotherapy causes delayed complications Fibrosis and secondary malignancy matter years later.

The 5 most tested oncology subtopics

1) Cancer screening & surveillance

Expect questions on colorectal, breast, cervical, and prostate cancer screening. NICE guidance is the reference standard in the UK:https://www.nice.org.uk/guidance/ng12

Typical exam angle: Who should be referred urgently?

2) Tumour markers

Know associations and limitations.

Marker	Common Association	Key Exam Point
AFP	Hepatocellular carcinoma	Diagnosis & monitoring
PSA	Prostate cancer	Monitoring, not screening alone
CA-125	Ovarian cancer	Disease burden, not early detection
CEA	Colorectal cancer	Detecting recurrence
β-hCG	Germ cell tumours	Diagnosis & follow-up

A normal tumour marker does not exclude malignancy.

3) Paraneoplastic syndromes

Highly testable because they cross systems.

Classic pairings:

• SIADH → small-cell lung cancer

• Hypercalcaemia → squamous cell carcinoma

• Dermatomyositis → ovarian or lung cancer

• Acanthosis nigricans → gastric carcinoma

4) Oncological emergencies

MRCP Part 1 tests recognition and first management step.

High-yield emergencies:

• Spinal cord compression

• Neutropenic sepsis

• Tumour lysis syndrome

• Superior vena cava obstruction

Steroids before imaging in suspected cord compression is a recurring principle.

5) Complications of cancer treatment

You are more likely to be asked about toxicity than efficacy.

Examples:

• Anthracyclines → cardiomyopathy

• Bleomycin → pulmonary fibrosis

• Cisplatin → nephrotoxicity, ototoxicity

• Cyclophosphamide → haemorrhagic cystitis

Mini-MCQ with explanation

Question A 67-year-old man presents with confusion, constipation, and bone pain. Corrected calcium is 3.2 mmol/L. Chest X-ray shows a central lung mass. What is the most likely mechanism?

A. Bone metastases causing osteolysisB. Ectopic ACTH secretionC. Parathyroid hormone-related peptide secretionD. Vitamin D excessE. Renal impairment

Correct answer: C

Explanation: Squamous cell carcinoma of the lung commonly causes hypercalcaemia via PTH-related peptide. Bone metastases alone rarely cause rapid, severe hypercalcaemia. Confusion is a classic symptom of high calcium.

Common oncology traps in MRCP Part 1

• Using tumour markers as screening tests

• Delaying treatment in oncological emergencies

• Overestimating cancer risk in young patients

• Ignoring paraneoplastic clues

• Memorising drug names instead of toxicities

Practical study checklist (exam-focused)

• Revise NICE urgent referral criteria

• Link paraneoplastic syndromes to tumour types

• Learn 10 classic chemotherapy toxicities

• Practise mixed oncology questions from a reliable Qbank

• Sit timed mock tests to improve pattern recognition

You can practise systematically using the Crack Medicine MRCP Question Bank:https://crackmedicine.com/qbank/

And track exam readiness with full-length mocks:https://crackmedicine.com/mock-tests/

FAQs

How many oncology questions are in MRCP Part 1?

Usually around 20–30, often integrated with other specialties rather than standalone oncology blocks.

Do I need to memorise chemotherapy regimens?

No. Focus on mechanisms, toxicities, and complications.

Are tumour markers high-yield for the exam?

Yes—especially knowing when not to use them.

What oncology topic is most commonly tested?

Screening principles and paraneoplastic syndromes appear most frequently.

Ready to start?

Oncology in MRCP Part 1 rewards clinical reasoning over rote learning. If you master screening rules, paraneoplastic syndromes, emergencies, and treatment complications—and practise regularly—you can secure easy marks in a topic many candidates fear.

For structured revision, start with the MRCP Part 1 hub at Crack Medicine:https://crackmedicine.com/mrcp-part-1/

Sources

• MRCP(UK) Examination Syllabus – https://www.mrcpuk.org

• NICE Suspected Cancer Guidelines (NG12) – https://www.nice.org.uk/guidance/ng12

• Oxford Handbook of Oncology