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------------------------------------------------ A 65-year-old man is evaluated during a visit to establish care. He is interested in colorectal cancer screening; however, he adamantly refuses to undergo colon preparation and does not want to modify his diet for screening. He has never undergone colorectal cancer screening. Medical and family histories are unremarkable. He takes no medications. Physical examination, including vital signs, is normal. After discussing the colon preparation process and dietary restrictions with the patient and exploring his concerns, he is steadfast in his refusal.

What is the most appropriate screening test for this patient?

A suitable colorectal cancer screening for a patient who declines colon preparation and dietary modifications is a non-invasive stool-based test such as FOBT, FIT, or a stool DNA test.

Explanation:

For a 65-year-old man who refuses colon preparation and dietary modifications for colorectal cancer screening, an appropriate test would be a non-invasive stool-based screening. Options include the fecal occult blood test (FOBT) or fecal immunochemical test (FIT), which detect hidden blood in the stool, or a stool DNA test, which can find DNA changes from cancer or polyps. These tests do not require any preparation or diet change and can be done at home. If any of these tests return a positive result, a follow-up colonoscopy would typically be recommended to visualize the colon and rectum and remove any polyps found.