PAEA Surgery End Of Rotation (EOR) Practice Exam

What increased testing should be performed on a high-risk patient for colorectal cancer?

1. Genetic blood testing and annual skin checks

2. Regular colonoscopies and mammography

3. Genetic blood testing and screening for UC or Crohn's after 10 years

4. Biannual CT scans and MRI

The correct answer is: Genetic blood testing and screening for UC or Crohn's after 10 years

Colorectal cancer screening for high-risk patients is essential to detect any precursors to cancer, such as polyps or early-stage cancers, that may otherwise go unnoticed. For individuals at high risk—due to family history, personal history of inflammatory bowel disease (IBD) like ulcerative colitis (UC) or Crohn's disease, or certain hereditary syndromes like Lynch syndrome—the guidelines recommend more intensive screening protocols. In the case of patients who have had inflammatory bowel diseases for an extended period, specifically more than 8 to 10 years, the risk of developing colorectal cancer significantly increases. As a result, it is recommended that these patients undergo regular surveillance colonoscopies. Additionally, genetic blood testing can identify mutations that predispose individuals to colorectal cancer, making it vital for high-risk patients. This proactive approach helps in early detection and improved management of potential cancer development. Other options, while they may include elements of care that are relevant to certain populations, do not match the specific requirements for colorectal cancer screening in high-risk individuals. Regular colonoscopies alone without the context of first-line assessments for hereditary factors adds less value compared to a combination of genetic testing and surveillance for IBD. Mammography is not pertinent to colorectal cancer screening. Bi