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Suspected Colorectal Cancer — RACP Adult Medicine MCQ

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EasyGastroenterologySuspected Colorectal CancerRACP Adult Medicine

A 75-year-old man presents with a 6-month history of weight loss and iron deficiency anaemia (Hb 88 g/L, ferritin 6 μg/L). He has a change in bowel habit to looser stools. Faecal immunochemical test (FIT) is positive. What is the most appropriate investigation?

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Correct answer: A — Colonoscopy

Iron deficiency anaemia with altered bowel habit, weight loss, and positive FIT in a man over 50 mandates colonoscopy to exclude colorectal carcinoma. This is the gold standard investigation. Bidirectional endoscopy (OGD + colonoscopy) may be performed if no cause is found on colonoscopy alone.

Reference: Cancer Council Australia – 2024 – Colorectal Cancer Screening Guidelines; NHMRC