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What is the appropriate mode of colorectal cancer screening for the following case?
A 44-year-old man whose father died of colon cancer at age 77 and who is asymptomatic.
(A) Colonoscopy now and every 10 years
(B) Flexible sigmoidoscopy now and every 5 years
© Colonoscopy at age 50 and every 10 years
(D) Colonoscopy now and every 10 years
(E) Stool occult cards every year; colonoscopy if positive
(F) Colonoscopy at age 40 and every 5 years
(G) Colonoscopy in 3 years
(H) Colonoscopy in 1 year
(I) Colonoscopy every 1 to 2 years
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c) colonoscopy for every 10 years from 50 and signoidscopy every 5years
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yes C earlier if positive family history at young age in a relative
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What is the source?
High risk if 1st degree relative with colon cancer before age 60
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The answer shuld be F. Any Pt who has a first degree relative w/ Hx of coloncancer will have to start colonoscopy 10 years earlier than the normal time (e.g 50) or if Relative was Dx with cancer age 45 for examp;e than the Pt would get colonoscopy at age 35. So whichever comes first, and that depend on the 1st degree relatives age.
This rule will vary though if the Pt relative had Familial polipsosis.. (kaplan decribes the age on whencolocscopy shud be done in those cases)
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ben i ve read it as it s screening should be done for anybody after 50 or 10 years before the youngest affected individual in the family....so should we take 77 as youngest affected and do screening at 67 years....but what i thought was there was no youngest individual affectd like a elder bro or sister...so i chose C as there is no risks compared to gen pop..any comments
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ok this is how it goes according to Kaplan notes
Normally screeining begins at 50 w/ colonsocopy every 5 years
In Pt with 1st degree relative you do start screeing 10 years earlier (e.g 40) or 10 years before the youngest affected individual in the family, whichever comes 1st. Since Pt is 77 screeingn at 67 is to late so you have to starts at age 40 as this is the earlier than age 67.
