An older African American patient at risk for colon cancer should be screened using which method at the recommended interval?

An older African American patient at risk for colon cancer should be screened using which method at the recommended interval?

• A. Colonoscopy every 2 years
• B. Serum cancer marker testing annually
• C. Flexible sigmoidoscopy testing annually
• D. Fecal occult blood screening every 2 years

Answer: (A)

Colonoscopy is the screening method of choice for someone at higher risk because it provides a full view of the entire colon and allows immediate removal of polyps during the same procedure, which both detects cancer early and reduces cancer risk. In individuals with increased risk—such as older patients and those in higher-risk populations—the surveillance is more frequent to catch any developing lesions sooner. That makes colonoscopy the most effective option among the choices, even though the interval is shorter than the average-risk recommendation. Other screening approaches don’t offer the same combination of full-colon visualization and therapeutic polyp removal. Serum cancer markers lack sufficient sensitivity and specificity for screening colon cancer. Fecal occult blood testing, while noninvasive, misses many cancers and polyps. Flexible sigmoidoscopy examines only part of the colon and may miss lesions in the proximal colon.

Colonoscopy is the screening method of choice for someone at higher risk because it provides a full view of the entire colon and allows immediate removal of polyps during the same procedure, which both detects cancer early and reduces cancer risk. In individuals with increased risk—such as older patients and those in higher-risk populations—the surveillance is more frequent to catch any developing lesions sooner. That makes colonoscopy the most effective option among the choices, even though the interval is shorter than the average-risk recommendation.

Other screening approaches don’t offer the same combination of full-colon visualization and therapeutic polyp removal. Serum cancer markers lack sufficient sensitivity and specificity for screening colon cancer. Fecal occult blood testing, while noninvasive, misses many cancers and polyps. Flexible sigmoidoscopy examines only part of the colon and may miss lesions in the proximal colon.