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Colorectal cancer — MCCQE Part 1 MCQ

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ModerateRectal BleedingColorectal cancerMCCQE Part 1

A 62-year-old man has altered bowel habit, visible rectal bleeding and iron deficiency anaemia, with no haemorrhoids on examination. Which of the following is the most appropriate next step?

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Correct answer: ARefer urgently for colonoscopy

Refer urgently for colonoscopy is the single best answer because the age, timing, examination findings and investigations in the vignette fit Colorectal cancer better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Association of Gastroenterology colorectal cancer guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Association of Gastroenterology colorectal cancer guidance