Question 9. 
 
A 59-year-old man was referred because of a change in bowel habit. He had noticed no 
alteration in stool calibre, gastrointestinal bleeding or unintended weight loss. There was no 
family history of colonic polyps or gastrointestinal malignancy. 
 
Physical examination was normal. A rectal examination revealed no masses. A 
sigmoidoscopy revealed a 4-mm polyp in the mid-rectum, which was removed with forceps, 
and histology revealed a tubular adenoma. 
 
What is the most appropriate next step in management? 
 
A  barium enema now 
B  colonoscopy in 3 years 
C  colonoscopy in 5 years 
D colonoscopy now 
E  sigmoidoscopy in 1 year