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MEN2A Screening — RACP Adult Medicine MCQ

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HardEndocrinologyMEN2A ScreeningRACP Adult Medicine

A 42-year-old MLH1 pathogenic-variant carrier has a 6 mm adenoma removed at surveillance colonoscopy. Bowel preparation and caecal intubation were satisfactory. What ongoing colorectal strategy is most appropriate?

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Correct answer: C — Continue high-quality colonoscopy every one to two years

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

C is correct. Lynch syndrome has an accelerated adenoma–carcinoma sequence; removal of one adenoma does not remove inherited field risk, so frequent high-quality colonoscopy continues. A under-surveils. B FIT is not an adequate substitute. D CT colonography cannot remove lesions and is less sensitive for small adenomas. E aspirin may reduce risk but does not replace surveillance.

Reference: Cancer Council Australia, Clinical practice guidelines for colorectal cancer: https://www.cancer.org.au/clinical-guidelines/bowel-cancer