DrVirgo
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When do we start screening annually for Colon cancer using the FOBT in the healthy population?
A. 35
B. 40
C. 45
D. 50
E. 55
F. 60
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| Ivonne
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Average people at 50------>D
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| DrVirgo
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Yes, thats right.
What if there is a family history in a first degree relative of having an adenomatous polyp but not cancer in that relative after the age of 50? Would this change our screening for FOBT?
Edited by DrVirgo on 01/13/08 - 06:04 AM
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| Ivonne
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If the relative has adenomatous polyps, what kind tubulus, villous, tubulovillous? then the relative needs colonoscopy each 3 years.
But i don't think it will change the screening in our patient unless clear family history of colon cancer then the screening should be started at 40 or 10 years earlier of the age of the relative with colon cancer which ever comes first.
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| DrVirgo
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Ok, here's the question:
A 35 year old woman in good health comes to the clinic for her annual physical exam. She is in her usual state of health and has no complaints. Prior to leaving, she asks about colorectal cancer screening. Her 58 year old fater had a flexible sigmoidoscopy performed six weeks ago for screening, and had a single adenomatous polyp removed. No cancer was found. His previous tests for colorectal cancer screening had been negative. As far as she knows, no other family members have a history of colorectal cancers or polyps. She has never been screened for colorectal cancer. Which of the following is the most appropriate screening regimen for this patient?
A. DRE every year beginning now
B. FOBT every year beginning at the age of 40
C. Flix sig every 5 years beginning now
D. Flex sig every 5 years beginning at the age of 50
E. Colonoscopy every 5 years beginning at the age of 40
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| Ivonne
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DRE: digital rectal exam
I will go with D
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| DrVirgo
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The right ans is B. FOBT every year beginning at the age of 40
The explanation says:
Asymptomatic with a FH of Colorectal Cancer OR Polyps -Start Screening at 40 years old.
Asymptomatic with NO FH, start Screening at 50.
They guidelines for both of the above are:
1. FOBT annually
2. Flex sig Q5 years
3. Both 1 and 2
4. Colonoscopy Q10 years
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| arlete
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Interesting. 
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| DrVirgo
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arlete wrote:Interesting.
Yeah, I thought we only start screening early (at 40 or 10years before the dx of the relative) if there is FH of first degree relative with actual COLON CANCER... Adenomatous polyps are mostly benign, correct? Plus in this question the relative was found to have adenomatous polyp at the age of 58 which is pretty late.
Anyway, interesting is right. 
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| Ivonne
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Nice info, thanks DrVirgo
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| fail
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really interesting
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