American Board of Internal Medicine (ABIM) Certification Practice Exam

For individuals at risk of MYH-Associated Polyposis, how often should colonoscopy be performed starting at age 25 to 30 years?

1. Every 1 year

2. Every 2 to 3 years

3. Every 5 years

4. Every 10 years

The correct answer is: Every 2 to 3 years

Individuals at risk for MYH-Associated Polyposis are recommended to undergo colonoscopy every 2 to 3 years starting at age 25 to 30 years. This screening frequency is designed to effectively monitor for the development of colorectal cancer, given the predisposition these individuals have due to MYH mutations. MYH-Associated Polyposis is characterized by the presence of multiple adenomatous polyps, which can increase the risk of colorectal cancer significantly. The rationale for the 2 to 3-year interval lies in the need to balance the detection of potentially cancerous polyps while avoiding excessive exposure to the risks associated with more frequent procedures. This interval allows for timely removal and monitoring of polyps before they progress to cancer, thereby improving patient outcomes. In considering other screening intervals, options that involve more frequent colonoscopies may not provide additional benefits in terms of cancer prevention over the 2 to 3-year recommendation. Similarly, longer intervals, such as 5 or 10 years, may lead to missed opportunities to detect and remove polyps early, putting patients at greater risk for developing colorectal cancer.