Comprehensive and Detailed Explanation:

Given his age and a first-degree relative with colon cancer diagnosed before age 60, this patient meets criteria for early colon cancer screening. Colonoscopy is the gold standard for both screening and diagnosis in this context.

Toronto Notes 2023 – Gastroenterology, “Colorectal Cancer Screening”:

“Patients with a first-degree relative diagnosed with colorectal cancer before age 60 should begin screening at age 40, or 10 years before the relative’s diagnosis. Colonoscopy is the preferred method.”

MCCQE1 Objectives (Population Health > Preventive Screening > 63-1):

“Candidates must apply colorectal cancer screening guidelines and select appropriate tests based on risk level.”

FIT (A) is for average-risk screening. MRI (B) and CT colonography (E) are secondary. Barium enema (D) is outdated.

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