American Board of Internal Medicine (ABIM) Certification Practice Exam

What interval is suggested for upper endoscopy surveillance for duodenal cancer in patients with duodenal polyposis?

1. Every year

2. Every 1 to 5 years

3. Every 3 to 4 years

4. Every 5 to 10 years

The correct answer is: Every 1 to 5 years

For patients with duodenal polyposis, it is important to conduct upper endoscopy surveillance with a recommended interval of every 1 to 5 years. This frequency balances the need for early detection of duodenal cancer, which can arise in the context of genetic syndromes such as familial adenomatous polyposis (FAP) or other conditions associated with polyposis. Duodenal polyposis increases the risk for duodenal adenomas and subsequent cancer development. Surveillance within this recommended timeframe allows for timely identification and intervention if dysplastic changes or malignancies are detected, thus improving patient outcomes. The variability in the surveillance interval (1 to 5 years) considers individual risk factors including the number, size, and histological features of the polyps, which can guide clinicians in determining the most appropriate monitoring frequency for each patient.