American Board of Internal Medicine (ABIM) Certification Practice Exam

At what age should screening for colon cancer begin for those at above average risk?

1. Age 50

2. Age 40

3. Age 45

4. Age 55

The correct answer is: Age 40

Screening for colon cancer is recommended to begin at age 40 for individuals who are classified as above average risk. This higher risk category includes those with personal or family histories of colon cancer or precancerous polyps, as well as certain genetic syndromes like Lynch syndrome or familial adenomatous polyposis. Given these elevated risk factors, starting screening earlier than the standard recommendation for average-risk individuals (which is age 45 or 50, depending on guidelines) is crucial for early detection and prevention of colorectal cancer. In general, guidelines suggest that individuals at average risk initiate screening at age 45; however, those with additional risk factors necessitate an earlier start to successfully identify potential malignancies before they progress. This proactive approach is crucial given the potential for increased cancer development in this population compared to their average-risk counterparts.