Aashi
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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
(C) 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
(J) Colonoscopy at the age of 40 and every 10 years
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| prathapdoctor
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C.
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| robin082006
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he has history of colon cancer so we should do screening test at age 40.
I go with F
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| ling
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f
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| doc_clotaire
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But what I don ' t understand is the question said :
What is the appropriate mode of colorectal cancer screening for the following case?
So , I would pick the answer who say colonoscopy NOW
If the question 'd say what WOULD BE the best screening test for this patient , I would pick F , because that would best answer in this case , but the patient is already 44 yo . I MUST ACT NOW so if I have to do a colonoscopy , it 's gotta be NOW
Now there are 2 options that say : Colonoscopy now and every 10 years ( A and D ) may be it 's a mistake . Anyway , Anyone of them would be my bet .
But The best answer should be :
COLONOSCOPY NOW AND EVERY 5 YEARS
Please, Correct me if I am wrong !
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| mjl1717
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i go with answer-f
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| CocaCola
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c - colonoscopy at 50 and every ten years thereafter
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| nadiabarati
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C
his father died of it at 77! So the patient doesn't have more risk than general population I guess!
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| Aashi
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Answer:
(F) Colonoscopy at age 40 and every 5 years
Explanation:
Colonoscopy is the preferred method of screening for colon cancer. Average-risk persons should undergo colonoscopy at age 50, and if normal, every 10 years. If a polyp is found, the colonoscopy should be repeated after 3 years. When there is a family history of colon cancer, screening should begin at age 40 or ten years prior to the age of the family member. The earlier date is respected. Follow-up examinations for persons with family histories of colon cancer should occur at 5-year intervals. When there are multiple family members, screening colonoscopy should be performed at age 25 and every 1 to 2 years (characteristic of persons with hereditary nonpolyposis colorectal cancer (Lynch syndrome). Colonoscopy is recommended 1 year after a hemicolectomy for colon cancer to verify the absence of recurrence and the presence of new lesions.
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| prathapdoctor
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in kaplan and harrison,its mentioned that if the colon cancer occurs in a single first degree relative earlier than 60 yrs,then we have to do colonoscopy at the age of 40 yrs in that patient and that should be repeated every 3 to 5 yrs.
in this case,his father had colon cancer at an age of 77,then how the previous rule applies to this case.
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| Aashi
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Well Dr.pratap, even i had the same q, and u r rt....but if u read the q carefully ,it says 'his father DIED of colon cancer at age 77' , it might have been detected much earlier , probably before or at age 60--->Having a close relative (brother, sister, parent or child) who has had colorectal cancer before age 60--> Is one of the criteria for early screening for colon CA, and NOT the age of the pt when he died coz of colon CA....
Hope u got the point.
GL
Edited by Aashi on 03/05/07 - 09:31 AM
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| hypochondriac
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Will a question on the USMLE really be that tricky? We really have no way of knowing when the father developed colon cancer. Were assuming it occurred before 60 that's why the answer is F.
On the actual exam won't they give us more information?
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| nadiabarati
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living 18 years with colon cancer?
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| star1
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Agree with Aashi
(F) Colonoscopy at age 40 and every 5 years
having positve family history so F seem to be the right option!!!
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| webjeee
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Idon't think his father died of colon cancer at age 77 is a positive history.
If somebody argue that died at 77 not diagnosed at 77, then when it was diagnosed. Nobody can answer the question. Probably before 60, according to average surviral years. so C. is the answer for real test I will pick.
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| DrVirgo
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Good point Aashi... I trust Conrad Fischer too... Keep posting these questions! They are pretty good!
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