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Lynch syndrome confers a markedly elevated lifetime risk for colorectal cancer and accelerated adenoma–carcinoma sequence. Evidence-based surveillance begins early—typically age 20–25 years or 2–5 years before the youngest family case—and is repeated at 1–2 year intervals, with shorter intervals for prior adenomas, poor prep, or additional risk factors. Colonoscopy is preferred over noninvasive stool testing (Option C) due to higher sensitivity for flat lesions and the need for immediate polypectomy. CT colonography (Option D) lacks therapeutic capability and exposes to radiation; it is considered only when colonoscopy is incomplete. Waiting until 50 and using 10-year intervals (Option A) applies to average risk and would miss early, rapidly progressing lesions in Lynch. The APRN should coordinate genetic counseling, discuss gynecologic risk management (endometrial/ovarian), aspirin chemoprevention considerations, and cascade testing for relatives. Document a survivorship plan specifying intervals, endoscopist experience needs, and symptom red flags warranting earlier evaluation.