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Family-history colorectal cancer screening — ABIM Board MCQ

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HardGeneral Internal MedicineFamily-history colorectal cancer screeningABIM Board

A 46-year-old man has never undergone colorectal cancer screening. His father developed colorectal cancer at age 52; there are no other affected relatives or features of a hereditary syndrome. Which screening plan is most appropriate now?

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

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Correct answer: D — Perform colonoscopy now and, if normal, repeat it in five years

The best answer is “Perform colonoscopy now and, if normal, repeat it in five years”. A first-degree relative diagnosed before age 60 places him in an increased-risk group. Screening should have begun at age 40 or 10 years before his father’s diagnosis, whichever came first; he is therefore overdue. Colonoscopy at five-year intervals is recommended rather than an average-risk stool strategy or ten-year interval.

Reference: ACG Clinical Guidelines: Colorectal Cancer Screening 2021: https://pubmed.ncbi.nlm.nih.gov/33657038/