A 58-year-old man presents with a 3-month history of hematochezia, pencil-thin stools, and altered bowel habits. Colonoscopy reveals an "apple-core" lesion in the sigmoid colon. Histopathology shows the structure marked **A** (invasive atypical glands) breaching the muscularis propria with surrounding desmoplastic stromal response. Based on the location and presentation, which of the following screening recommendations would have been most appropriate for this patient at age 45?