American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended surveillance for patients with inflammatory bowel disease regarding colon cancer?

1. Standard age-based screening

2. Every 3 years after diagnosis

3. Annual screening starting at age 40

4. Screening before the age of 50 only

The correct answer is: Every 3 years after diagnosis

The recommended surveillance for patients with inflammatory bowel disease (IBD) regarding colon cancer is to begin screening with colonoscopy every 1 to 3 years starting 8 years after the initial diagnosis of IBD. This is because individuals with IBD, especially those with ulcerative colitis or Crohn's disease involving the colon, are at an increased risk of developing colorectal cancer. The choice of conducting surveillance every 3 years aligns well with the guidelines that advocate for more frequent monitoring in this high-risk population compared to the standard age-based screening that is typical for the general population, which usually starts at age 45 or 50. Regular screenings allow for the detection of dysplastic changes or early cancers, which is crucial for improving outcomes. While some options might refer to age-based screening or specific age thresholds, the focus should remain on the timeline from diagnosis, along with the increased cancer risk due to the underlying chronic inflammation associated with IBD. This proactive approach to surveillance is essential and reflects the understanding of the unique risks that patients with inflammatory bowel disease face.