Which test is not typically recommended for colorectal cancer screening in someone with a first-degree relative with colon cancer?

• A. Fecal occult blood testing
• B. Sigmoidoscopy
• C. Colonoscopy
• D. Abdominal ultrasound

Answer: (D)

When assessing colorectal cancer risk in someone with a first-degree relative who had colon cancer, the approach centers on tests that either visualize the colon or detect bleeding from a possible tumor. Abdominal ultrasound does not visualize the colon well and is not sensitive for detecting polyps or early cancers, so it isn’t used as a screening tool for colorectal cancer.

In contrast, tests like fecal occult blood testing can pick up hidden blood from a lesion, flexible sigmoidoscopy screens the distal colon, and colonoscopy visualizes the entire colon and allows biopsy or removal of polyps. Because higher-risk individuals benefit from the most comprehensive evaluation, colonoscopy is typically preferred, with earlier initiation and closer follow-up intervals. Therefore, the test not typically recommended for routine colorectal cancer screening in this high-risk group is abdominal ultrasound.