A 50-year-old man presents to his physician’s office for a routine preventive health visit. He feels well and has no gastrointestinal symptoms. He has never had colorectal cancer screening. His medical history is significant only for hypertension treated with lisinopril. He has no family history of colorectal cancer. Vital signs are within normal limits. Physical examination is unremarkable.
Which of the following is the most appropriate recommendation regarding colorectal cancer screening?
The correct answer is:
A: Begin screening colonoscopy now.
Average-risk adults should begin colorectal cancer screening at age 45 years. Colonoscopy is one accepted screening strategy and allows both detection and removal of precancerous lesions. This patient has already reached screening age and should undergo screening.
Answer choice B: Begin screening colonoscopy at age 60 years, is incorrect.
This recommendation does not reflects current screening practices and would unnecessarily delay detection of premalignant lesions.
Answer choice C: No screening is necessary unless symptoms develop, is incorrect.
The goal of screening is to detect disease before symptoms occur. Waiting for symptoms reduces the opportunity for prevention.
Answer choice D: Stool DNA testing every month, is incorrect.
Stool DNA testing is an accepted screening option but is not performed monthly. The interval is substantially longer (typically yearly).
Answer choice E: Yearly upper endoscopy, is incorrect.
Upper endoscopy does not screen for colorectal cancer.
Key Learning Point
Average-risk adults should begin colorectal cancer screening at age 45 years using an approved screening strategy such as colonoscopy.
