Riddler Question #1Riddler Question #1

A thirty-three year old male is seen A thirty-three year old male is seen for a scheduled apt for GERD and for a scheduled apt for GERD and inquires about colon cancer inquires about colon cancer screening. He is a nonsmoker, screening. He is a nonsmoker, nondrinker, active duty duty male. nondrinker, active duty duty male. His father died of colon cancer at the His father died of colon cancer at the age of 54, two years after his initial age of 54, two years after his initial diagnosis. At what age are you diagnosis. At what age are you going to recommend initiation of going to recommend initiation of colon cancer screening?colon cancer screening?

Riddler Question #1 Riddler Question #1 Con’t.Con’t. A) 50A) 50 B) 55B) 55 C) 40C) 40 D) NowD) Now

Riddler #1 - AnswerRiddler #1 - Answer

C) 40 y/oC) 40 y/o Average risk: fecal occult blood test annually or Average risk: fecal occult blood test annually or

sigmoidoscopy every 5 years or both, or Colonoscopy every sigmoidoscopy every 5 years or both, or Colonoscopy every 10 years10 years

One 1One 1stst degree relative with colorectal cancer or two second degree relative with colorectal cancer or two second degree relatives: 40 years old and screen with colo every degree relatives: 40 years old and screen with colo every 10 years10 years

Two or more 1Two or more 1stst degree relatives or one 1 degree relatives or one 1stst degree relative degree relative diagnosed at <40 years of age: 40 years old or 10 years diagnosed at <40 years of age: 40 years old or 10 years younger than the earliest patient and screen every 5 yearsyounger than the earliest patient and screen every 5 years

Inflammatory bowel disease: colonoscopy every 1-2 years Inflammatory bowel disease: colonoscopy every 1-2 years with multiple biopsieswith multiple biopsies

The American cancer Society, The United States Preventive Services Task The American cancer Society, The United States Preventive Services Task Force, and the GI Consortium Panel (Smith et al.; Pignone et al)Force, and the GI Consortium Panel (Smith et al.; Pignone et al)