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Colon cancer surveillance — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Colon cancer surveillanceUSMLE Step 3

A 62-year-old had urgent resection of an obstructing stage II colon cancer. Complete colonoscopy could not be performed before surgery. He is four months postoperative and asymptomatic. Which next endoscopic plan is best?

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

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Correct answer: A — Perform a clearing colonoscopy now to evaluate for synchronous lesions

When obstructing colorectal cancer prevents a complete preoperative examination, the colon should be cleared with colonoscopy within three to six months after surgery. This evaluates for synchronous neoplasia before the usual surveillance interval.

Reference: ACG: Colonoscopy Surveillance After Colorectal Cancer Resection: https://gi.org/journals-publications/acg-blog/new-joint-guidelines-urge-colonoscopy-after-crc-resection/