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Bleeding colorectal cancer — MCCQE Part 1 MCQ

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HardRectal BleedingBleeding colorectal cancerMCCQE Part 1

A 66-year-old woman presents with 2 months of intermittent rectal bleeding, change in bowel habit and 5 kg weight loss. She is haemodynamically stable, haemoglobin is 96 g/L, and rectal examination shows no haemorrhoids. What is the most appropriate investigation?

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Correct answer: B — Urgent colonoscopy

Rectal bleeding with anaemia, weight loss and altered bowel habit is diagnostic evaluation territory, not population screening. Colonoscopy allows direct assessment and biopsy of suspected colorectal cancer. A fibre trial would be unsafe because alarm features are present.

Reference: Canadian Association of Gastroenterology guidance; CTFPHC colorectal cancer screening