AANP Family Nurse Practitioner (FNP) Certification ExamPlanMedium
A 70-year-old female presents for her annual physical examination. She has a history of type 2 diabetes, hypertension, and dyslipidemia, all well-controlled. Her last colonoscopy was 12 years ago with no polyps found. She asks the FNP about recommended cancer screenings. Based on current guidelines for a patient of her age and history, which screening recommendation is most appropriate?
- ADiscontinue all colorectal cancer screening.
- BOffer a stool-based test for colorectal cancer annually.
- CContinue annual colonoscopy screenings.
- DRecommend a repeat colonoscopy in 3 years.
Show answer & explanationAnswer & explanation
Correct answer: B. Offer a stool-based test for colorectal cancer annually.
For individuals aged 70-75 with a negative colonoscopy 10 years prior, guidelines suggest individualized decision-making regarding continued screening. Stool-based tests (like FIT or gFOBT) are often preferred for their less invasive nature and annual frequency, making them a reasonable option for continued screening in this age group who still benefits from screening.
Why the other options are wrong
- A. Screening for colorectal cancer is generally recommended up to age 75 for individuals with average risk and good health, so discontinuing entirely is premature.
- C. Annual colonoscopies are not typically recommended for average-risk individuals, especially after a negative screen 10 years prior; the interval is usually longer.
- D. A 3-year interval for colonoscopy is not standard for average-risk individuals after a negative screen; 10 years is typical, or 5 years if adenomas were found (which is not the case here).
Colorectal Cancer Screening Age 70-75
Colorectal cancer screening decisions for individuals aged 70-75 should be individualized, considering patient preferences, health status, and prior screening results.
- Screening generally recommended until age 75 for average risk.
- Options include colonoscopy (every 10 years if negative) or annual stool-based tests.
- Decision based on life expectancy, comorbidity, and patient values.
Memory trick: AGE, RISK, CHOICE: Age 70-75, Assess Risk, Offer Choices.