A 47-year-old man with a mother who had colon cancer at 47 years old (first-degree relative). What is his risk status and recommended screening?

A 47-year-old man with a mother who had colon cancer at 47 years old (first-degree relative). What is his risk status and recommended screening?

• A. Average risk; colonoscopy at 50
• B. Low risk; FOBT annually
• C. Moderate/high risk; colonoscopy now
• D. High risk; colonoscopy every 5 years starting now

Answer: (C)

A first-degree relative with colon cancer diagnosed at a young age markedly raises your risk. When that relative is under 60, the patient is considered increased risk (moderate to high) and the best screening approach is colonoscopy, not a stool-based test. Because the relative’s cancer occurred at 47, the typical starting point would be 10 years before that age, which would be 37; since you’re already 47, you should be screened now. Colonoscopy is preferred in this risk group because it can both detect and remove polyps, and the recommended interval is every 5 years due to the elevated risk. This plan is more appropriate than average-risk screening (which starts at 50) or FOBT alone, which wouldn’t provide the same level of protection for someone with this family history.

A first-degree relative with colon cancer diagnosed at a young age markedly raises your risk. When that relative is under 60, the patient is considered increased risk (moderate to high) and the best screening approach is colonoscopy, not a stool-based test. Because the relative’s cancer occurred at 47, the typical starting point would be 10 years before that age, which would be 37; since you’re already 47, you should be screened now. Colonoscopy is preferred in this risk group because it can both detect and remove polyps, and the recommended interval is every 5 years due to the elevated risk. This plan is more appropriate than average-risk screening (which starts at 50) or FOBT alone, which wouldn’t provide the same level of protection for someone with this family history.