POST-TEST: CRC Screening Guidelines Webcast

1. The most important step for the primary care clinician to perform as opposed to the office team is:

Assess risk for colon cancer

Recommend to the patient that they be screened for colon cancer

Remind patients to return the FOBT cards

Initiate the call to schedule a colonoscopy

The most important step for the primary care clinician is to recommend to the patient that they be screened for colon cancer. This is important because the primary care clinician is in direct contact with the patient and has the responsibility to inform and educate them about the importance of colon cancer screening. By recommending screening, the clinician can help detect any potential signs of colon cancer early on, increasing the chances of successful treatment and improving patient outcomes. This step empowers the patient to take action and prioritize their health by undergoing the necessary screening tests.

Explanation

The most important step for the primary care clinician is to recommend to the patient that they be screened for colon cancer. This is important because the primary care clinician is in direct contact with the patient and has the responsibility to inform and educate them about the importance of colon cancer screening. By recommending screening, the clinician can help detect any potential signs of colon cancer early on, increasing the chances of successful treatment and improving patient outcomes. This step empowers the patient to take action and prioritize their health by undergoing the necessary screening tests.

2. All of these approaches are recommended for colon cancer screening by the USPSTF EXCEPT:

Guiac-FOBT every year

Fecal Immunochemical Testing (FIT) every year

Flexible sigmoidscopy every 5 years plus FOBT or FIT every year

FOBT on a specimen obtained through digital rectal exam every year

Colonoscopy every 10 years

The USPSTF recommends several approaches for colon cancer screening, including Guiac-FOBT every year, Fecal Immunochemical Testing (FIT) every year, Flexible sigmoidoscopy every 5 years plus FOBT or FIT every year, and Colonoscopy every 10 years. However, FOBT on a specimen obtained through digital rectal exam every year is not recommended by the USPSTF for colon cancer screening. This method is not as accurate or effective as the other screening approaches mentioned.

Explanation

The USPSTF recommends several approaches for colon cancer screening, including Guiac-FOBT every year, Fecal Immunochemical Testing (FIT) every year, Flexible sigmoidoscopy every 5 years plus FOBT or FIT every year, and Colonoscopy every 10 years. However, FOBT on a specimen obtained through digital rectal exam every year is not recommended by the USPSTF for colon cancer screening. This method is not as accurate or effective as the other screening approaches mentioned.

3. The individual at highest risk for the development of colon cancer in the next 10 years is:

A 61-year-old woman who had four hyperplastic polyps removed at colonoscopy 15 months earlier

A 60-year-old woman who had two 0.4 – 0.6 cm adenomatous polyps removed at colonoscopy 4 months earlier

A 53-year-old man whose mother was diagnosed with colon cancer at age 71

A 46-year-old woman with a 19 year history of ulcerative colitis with an intact colon

The individual at highest risk for the development of colon cancer in the next 10 years is a 46-year-old woman with a 19-year history of ulcerative colitis with an intact colon. Ulcerative colitis is a known risk factor for the development of colon cancer, especially in individuals with a long duration of the disease. The chronic inflammation and damage to the colon lining in ulcerative colitis increase the likelihood of developing cancerous changes over time. Therefore, this individual has the highest risk compared to the other options provided.

Explanation

The individual at highest risk for the development of colon cancer in the next 10 years is a 46-year-old woman with a 19-year history of ulcerative colitis with an intact colon. Ulcerative colitis is a known risk factor for the development of colon cancer, especially in individuals with a long duration of the disease. The chronic inflammation and damage to the colon lining in ulcerative colitis increase the likelihood of developing cancerous changes over time. Therefore, this individual has the highest risk compared to the other options provided.

4. Elements of a high quality colonoscopy-based screening program include all of the following, EXCEPT:

Use of a patient registry

Initiation of an Open Access colonoscopy scheduling program

Initiation of an in-office flexible sigmoidoscopy program

Use of reminders for patients who were given home stool blood tests

Development of a single phone call colonoscopy scheduling system

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Explanation

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5. Advantages of FIT over guiac FOBT include all of the following, EXCEPT:

Higher sensitivity

Improved patient adherence

Randomized trials evidence of mortality reduction

No need for dietary modification

No need to stop non-steroidal anti-inflammatory agents

FIT (fecal immunochemical test) is a type of stool test used to detect blood in the stool, which can be an indication of colorectal cancer or other gastrointestinal issues. The advantages of FIT over guiac FOBT (guaiac-based fecal occult blood test) include higher sensitivity, improved patient adherence, no need for dietary modification, and no need to stop non-steroidal anti-inflammatory agents. However, randomized trials evidence of mortality reduction is not an advantage of FIT over guiac FOBT. This means that there is no conclusive evidence from randomized trials to support the claim that FIT reduces mortality rates compared to guiac FOBT.

Explanation

FIT (fecal immunochemical test) is a type of stool test used to detect blood in the stool, which can be an indication of colorectal cancer or other gastrointestinal issues. The advantages of FIT over guiac FOBT (guaiac-based fecal occult blood test) include higher sensitivity, improved patient adherence, no need for dietary modification, and no need to stop non-steroidal anti-inflammatory agents. However, randomized trials evidence of mortality reduction is not an advantage of FIT over guiac FOBT. This means that there is no conclusive evidence from randomized trials to support the claim that FIT reduces mortality rates compared to guiac FOBT.

6. All of these options for colorectal cancer screening result in approximately equal mortality reduction EXCEPT:

Fecal immunochemical testing annually

Colonoscopy every 10 years

Flexible sigmoidoscopy every 5 years

Sensitive guiac-based fecal occult blood test every year

Flexible sigmoidoscopy every 5 years is the exception because it only examines the lower part of the colon, whereas the other options (fecal immunochemical testing annually, colonoscopy every 10 years, and sensitive guiac-based fecal occult blood test every year) provide a more comprehensive examination of the entire colon. Therefore, the mortality reduction may be lower with flexible sigmoidoscopy as it may miss potential abnormalities in the upper part of the colon.

Explanation

Flexible sigmoidoscopy every 5 years is the exception because it only examines the lower part of the colon, whereas the other options (fecal immunochemical testing annually, colonoscopy every 10 years, and sensitive guiac-based fecal occult blood test every year) provide a more comprehensive examination of the entire colon. Therefore, the mortality reduction may be lower with flexible sigmoidoscopy as it may miss potential abnormalities in the upper part of the colon.

Post-test: CRC Screening Guidelines Webcast