A 54-Year-Old Man Comes to the Office Due to Intermittent

A 54-year-old man comes to the office due to intermittent episodes of blood in the stool over the past several weeks.  The blood is mixed in the stool, and he has also noticed bright red blood on the toilet paper.  The patient reports no prior medical conditions but has not seen a physician in many years.  Family history includes colon cancer in his paternal uncle.  Vital signs are within normal limits.  Physical examination shows a nondistended, soft, and nontender abdomen with no hepatosplenomegaly.  A palpable mass is present on digital rectal examination.  Flexible sigmoidoscopy confirms a fungating mass in the upper rectum; biopsy is consistent with adenocarcinoma.  Staging CT scans reveal no lung, liver, or bony metastases.  Which of the following is most appropriate prior to surgical treatment of this patient's condition?

A) Adenomatous Polyposis Coli gene testing
B) Colonoscopy of the entire colon
C) Endoscopy for gastric polyps
D) No additional testing
E) Sentinel inguinal lymph node biopsy

Correct Answer:

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