skip to main content

Colorectal Cancer Screening Dialysis — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardHaemodialysisColorectal Cancer Screening DialysisESENeph

A 65-year-old receiving haemodialysis has persistent iron-deficiency anaemia and a positive faecal immunochemical test. He is independent and would accept treatment if cancer were found. Which next step is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Lower-gastrointestinal investigation through the suspected-cancer pathway

Explanation lettering: C = shown as A · E = shown as B · B = shown as C · A = shown as E

A is correct. This is no longer a question about whether population screening is worthwhile: persistent iron deficiency plus a positive FIT is a diagnostic cancer signal in a patient fit enough to benefit from diagnosis and treatment. Dialysis can cause anaemia, but it does not explain away iron deficiency or invalidate FIT. B delays investigation and may increase haemoglobin without addressing occult blood loss. C invents a mandatory iron trial before investigation. D confuses diagnostic work-up with routine screening. The exact test is agreed with gastroenterology according to procedural risk and local pathway, but timely colonic evaluation is required.

Reference: NICE NG12: suspected cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer