NCLEX · General

The nurse is conducting a community health fair. Which screening test is most appropriate to offer for colorectal cancer to average-risk adults aged 50+?

Correct answer

Annual fecal occult blood test (FOBT) or fecal immunochemical test (FIT) — a non-invasive, inexpensive screening tool that detects blood in stool that may indicate colorectal cancer; colonoscopy every 10 years is the gold standard but requires bowel prep and sedation

  1. A Annual PSA test
  2. B Annual fecal occult blood test (FOBT) or fecal immunochemical test (FIT) — a non-invasive, inexpensive screening tool that detects blood in stool that may indicate colorectal cancer; colonoscopy every 10 years is the gold standard but requires bowel prep and sedation
  3. C Annual chest X-ray
  4. D Annual upper endoscopy

Why this is the answer

COLORECTAL CANCER SCREENING GUIDELINES: ACS recommends beginning at age 45 for average risk (lowered from 50 in 2018). OPTIONS range from non-invasive to invasive: STOOL TESTS: Annual FIT (fecal immunochemical test) — most practical for community screening; FOBT (guaiac-based) — less specific; FIT-DNA (Cologuard) — every 1-3 years; VISUAL EXAMS: Flexible sigmoidoscopy every 5 years; CT colonography (virtual colonoscopy) every 5 years; COLONOSCOPY: Gold standard; every 10 years for average risk; allows biopsy and polyp removal during the procedure; COMMUNITY HEALTH FAIR CONTEXT: FIT testing is ideal — it's inexpensive, no preparation required, can be completed at home, and results are highly actionable (positive → refer for colonoscopy). PSA is prostate cancer screening for men; chest X-ray screens for lung cancer (but low-dose CT is preferred); upper endoscopy screens for upper GI, not colorectal.
Source: NCLEX-RN Test Plan: Health Promotion — Cancer Screening, Colorectal

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