American Board of Internal Medicine (ABIM) Certification Practice Exam

How often should patients with familial adenomatous polyposis undergo upper endoscopy to screen for duodenal cancer?

1. Every year

2. Every 1 to 5 years

3. Every 3 to 7 years

4. Every 6 months

The correct answer is: Every 1 to 5 years

For patients with familial adenomatous polyposis (FAP), regular upper endoscopy is crucial for the surveillance of duodenal cancer due to the significant risk these patients face. These individuals have a higher likelihood of developing duodenal adenomas, which can progress to cancer if not monitored and treated in time. The recommendation for screening with upper endoscopy typically suggests that it should be performed every 1 to 5 years, depending on the individual patient's circumstances, including their age, family history, and the presence and number of duodenal polyps detected during previous screenings. This timeframe allows healthcare providers to adequately monitor the patient's duodenal health without unnecessary excessive intervention while ensuring timely detection and management of potential malignancies. This approach balances the need for vigilance against duodenal cancer and the practical considerations of patient management, avoiding both under-surveillance and over-surveillance.