indlaxman
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A 54-year-old man presents for a periodic health examination. His family history is significant for his mother who died of a cerebrovascular accident at age 72, his father who died of a myocardial infarction at age 68, and a brother who developed sigmoid cancer at age 60. The patient is on no medications except for aspirin, 81 mg daily. His physical examination is unremarkable. The patient asks for a recommendation regarding current cancer screening. Which of the following is the most appropriate screening test for this patient?
A. Annual digital rectal examination and fecal occult blood testing
B. Flexible sigmoidoscopy
C. Flexible sigmoidoscopy and barium enema
D. Colonoscopy
E. Genetic testing for the p53 gene
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| crista
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colonoscopy bz of sigmoid ca family hist.
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| miky
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no S/S, age 54, +FH/O colon cancer
Annual DRE & Occult blood test
If either or both positive - next: Flexible Rectosigmoidoscopy - if negative: full Colonoscopy - if any suspicious lesion found - Next:Biopsy
If the pt. had had S/S suggesting colon cancer, we could have started with Colonoscopy (sensitive)
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| crista
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over 50y, everybody has every 10y a colonoscopy and every year blood stool ex.; so, considering he is over 50 and has a hist., first: colonoscopy
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| miky
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so, what's the correct answer, Indira?
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| lucky
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its a . after 40 yrs every year. then comes sigmoidoscopy ,every 5 yrs, after 50.
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| mash
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i wud go with colonoscopy bcoz
--age of the person is >50 yrs
---there is hx of ca colon in 1st degree relative(his brother)
--- ca in his brother was diagnosed at the age of 60 [screening is started at 40 yrs (with colonoscopy every 10 yrs)]
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| yutaro
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| yutaro
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I choose colonscopy.
Because his family history and age are a good indication.
But the interesting point in this Q is asprin.
Taking aspirin for long is pervention of colon cancer reportedly.
otherwise, aspirin can be a cause of damaging gastric mucosa.
Anyway occult blood test is not enough, I think.
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| arpit
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colonoscopy is i think best for screening,
hey indira whats the answer
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| msashraf
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i think the answer is colonoscopy bcoz he has a h/o ca colon in family.so screening should have started at age 40 yrs.
as for digital rectal exam there is no protocol to screen for ca prostate.
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| tasneembanu
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why not flexible sigmoidoscopy?
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| intern_doc
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NOT flex sig b/c if the Cancer was higher up, you will NOT able to detect it with flex sig therefore it's better if you do colonoscopy
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