28th May 2025

A 62-year-old woman presents to her GP with a 2-month history of occasional fresh red PR bleeding on defecation.

A 62-year-old woman presents to her GP with a 2-month history of occasional fresh red PR bleeding on defecation. This has never happened previously. She reports otherwise feeling well with no abdominal pain, unintentional weight loss, change in appetite, tarry stool or change in bowel habit. She has a history of rheumatoid arthritis, hyperlipidaemia and type 2 diabetes mellitus. Abdominal and PR examinations are unremarkable. Blood tests reveal a microcytic anaemia with normal renal function, liver function and CRP.

How should this woman be investigated in the first instance?

Select the SINGLE most appropriate option from the list below. Select ONE option only.