American Board of Internal Medicine (ABIM) Certification Practice Exam

How often should individuals with MYH-associated polyposis undergo colonoscopy?

1. Every year starting at age 20

2. Every 2 to 3 years starting at age 25 to 30

3. Every 5 years starting at age 30

4. Every year starting at age 30

The correct answer is: Every 2 to 3 years starting at age 25 to 30

Individuals with MYH-associated polyposis should undergo colonoscopy every 2 to 3 years starting at age 25 to 30 because this approach balances the need for surveillance with the specific risk profile associated with the condition. MYH-associated polyposis is a hereditary condition that significantly increases the risk of developing colorectal cancer due to multiple adenomatous polyps in the colon. Initiating colonoscopy screenings at the age of 25 to 30 allows for early detection of any polyps that could become malignancies, responding appropriately to the elevated risk without excessive intervention too early in life. The recommended interval of every 2 to 3 years helps to monitor the progression of any polyps that may develop, allowing for timely removal and reducing cancer risk. The other intervals, such as every year starting at age 20 or every year starting at age 30, may be unnecessarily aggressive, potentially leading to overtreatment and increased healthcare costs without added benefit. Similarly, recommending an interval of every 5 years starting at age 30 is too infrequent given the moderate to high risk associated with this genetic condition, which may allow polyps to progress to advanced stages before being detected. Thus, the periodicity suggested in the correct choice aligns well with