American Board of Internal Medicine (ABIM) Certification Practice Exam

For patients who decline colon cancer screening with colonoscopy, which is a recommended alternative?

1. Annual fecal occult blood testing

2. CT colonography every 5 years

3. Regular physical examinations

4. Genetic testing

The correct answer is: CT colonography every 5 years

Choosing an alternative screening method for patients who decline colon cancer screening via colonoscopy is crucial for ensuring ongoing surveillance for colorectal cancer. CT colonography, also known as virtual colonoscopy, is a valuable non-invasive imaging technique that allows for visualization of the colon and can detect polyps and other abnormalities. When considering alternative screening options, CT colonography, performed every five years, is effective and provides similar sensitivity to traditional colonoscopy for the detection of significant lesions. It has the added advantage of being less invasive, which can be appealing to patients who refuse standard colonoscopy due to its associated discomfort or procedural risks. While annual fecal occult blood testing is another alternative, it requires more frequent testing and less comprehensive evaluation than CT colonography. Regular physical examinations and genetic testing, on the other hand, do not specifically address colorectal cancer screening and are not recognized as effective methods for routine colorectal cancer detection. Hence, CT colonography stands out as the recommended alternative in this context.