Presenting Concern: Routine screening for colon cancer
Risk Factors: No family history of colorectal cancer, no symptoms (e.g., no blood in stool, no
change in bowel habits), non-smoker, moderate alcohol use, healthy weight, exercises regularly.
Clinical Scenario:
John presents for his first routine screening for colorectal cancer, as recommended by the
American Cancer Society starting at age 45. He reports no gastrointestinal symptoms, such as
abdominal pain, bleeding, or changes in bowel habits. John’s primary care provider (PCP)
reviews his medical history and conducts a physical exam, which is unremarkable.
Assessment:
Age: 55 (within the age range for starting routine screening)
No symptoms or risk factors for colon cancer
No personal or family history of colorectal cancer
According to guidelines, individuals at average risk for colorectal cancer should start screening
at age 45 and continue until age 75, using methods like a colonoscopy every 10 years.
Plan:
1. Screening Recommendation:
oDiscussed the importance of early detection of colorectal cancer, even without
symptoms, and recommended colonoscopy as the screening method.
oColonoscopy is the gold standard for colorectal cancer screening, allowing not
only for detection but also for removal of polyps during the procedure.
2. Patient Education:
oEducated John on the colonoscopy process, including preparation (e.g., dietary
restrictions, bowel cleansing), potential risks, and benefits.
oAddressed any concerns about the procedure, including discomfort and anesthesia
options, and the importance of following through with the screening.
3. Scheduling the Procedure:
oJohn was provided with referral details to a gastroenterologist for scheduling the
colonoscopy.
oProvided clear instructions for pre-procedure preparation and fasting.
4. Follow-up:
oAfter the procedure, John will follow up with the PCP to review results. If the
colonoscopy is normal, the next screening will be in 10 years.
