MDcooper
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54 yr old pain,presents for periodic health exam.Family H/O mother died of CVA at age 72,father died of MI at age 68,brother died of sigmoid cancer at age 60.Pt is not on any medications except aspirin low dose.physical is unremarkable.Pt asks for recommendation regarding current cancer screening.Which of the following is the most appropriate screening test for this Pt?
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 p53 gene
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| study_ing
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between a and D...hm
id chose A but the bro dying at 60 og ca makes me confused.
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| sheeezooo
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D
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| saadtazjam
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D
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| tolito
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D.
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| yasmeen
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D
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| MDcooper
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yes the answer is D but the explanation says that for colon cancer screening,rectal exam is now obsolete and colonoscopy is done..this information is new for me.its just the number of years that varies after a first blood relation had cancer.that is at age 50 or 10 years before the relative was diagnosed with cancer.I understand that per rectal screening is still the standard in screening or I am wrong?
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| sunny2
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MDcooper , the American Cancer Society
Colorectal Cancer Screening Guidelines are :
Beginning at age 50, men and women who are at average risk for developing
colorectal cancer should have one of the 5 screening options below:
1. a fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every
year, or
2. flexible sigmoidoscopy every 5 years, or
3. an FOBT or FIT every year plus flexible sigmoidoscopy every 5 years, or
(Of these first 3 options, the combination of FOBT or FIT every year plus
flexible sigmoidoscopy every 5 years is preferable.)
4. double-contrast barium enema every 5 years, or
5. colonoscopy every 10 years
-------------------------------------------------------
People should talk to their doctor about starting colorectal cancer screening earlier and/or undergoing screening more often if they have any of the following colorectal cancer risk factors:
a personal history of colorectal cancer or adenomatous polyps
a strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in 2 first-degree relatives of any age)
a personal history of chronic inflammatory bowel disease
a family history of an hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer)
---------------------------------
High Risk Individuals
High-risk persons are defined as those persons with two or more first-degree relatives (mother, father or sibling) with colorectal cancer diagnosed at age less than 60.
Recommendation
Colonoscopy starting at age 40 or 10 years less than the youngest affected relative whichever is earlier.
Colonoscopy should be repeated every 3 to 5 years.
-----------------------------------
We should know all the above I think...then there would not be any sort of confusion 
Hope this helps 
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| MDcooper
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yes this sure helps.Actually in practice I have seen physicians only doing a PR and ruling out cancer in the annual exams a few close relatives of mine are having.They dont go to the extent of occult blood or colonoscopy.That is why I was confused...PR cant rule out the higher located Ca though..so above approach seems quite reasonable.
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| study_ing
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actually i tot of the PR for the prostate...definitely not rectal ca
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