Which factor most clearly indicates a need for priority colonoscopy screening based on the scenario?

Which factor most clearly indicates a need for priority colonoscopy screening based on the scenario?

• A. Nonie Masseur, age 48, sister with colon cancer
• B. Norma Williams, age 36, hemorrhoids
• C. Nancy Morgan, age 42, irritable bowel syndrome
• D. Anne Daniels, age 29, BRCA1 positive

Answer: (A)

Having a first-degree relative with colorectal cancer is a strong indicator for priority colonoscopy screening. When a sister is diagnosed with colon cancer, the risk for her first-degree relatives is significantly higher, so screening is started earlier than average risk—typically around age 40 or 10 years before the relative’s diagnosis, whichever comes first. The other factors shown don’t carry the same immediate implication: hemorrhoids are benign and common and don’t signal cancer; irritable bowel syndrome is a functional disorder with no cancer risk signal; BRCA1 positivity increases risk for breast and ovarian cancer, not colon cancer in a direct, guideline-driven way. Therefore, the scenario with a sister who has colon cancer most clearly necessitates priority screening.

Having a first-degree relative with colorectal cancer is a strong indicator for priority colonoscopy screening. When a sister is diagnosed with colon cancer, the risk for her first-degree relatives is significantly higher, so screening is started earlier than average risk—typically around age 40 or 10 years before the relative’s diagnosis, whichever comes first. The other factors shown don’t carry the same immediate implication: hemorrhoids are benign and common and don’t signal cancer; irritable bowel syndrome is a functional disorder with no cancer risk signal; BRCA1 positivity increases risk for breast and ovarian cancer, not colon cancer in a direct, guideline-driven way. Therefore, the scenario with a sister who has colon cancer most clearly necessitates priority screening.