Description

Mid-Level Flow Diagram

Most recent CRCscreening test iscolonoscopy?Most recent CRCscreening test isFOBT or FIT?Most recent CRCscreening test issDNA-FIT?Most recent CRCscreening test is CTcolonography?Most recent CRCscreening test isflexiblesigmoidoscopy?Update next due date 10 yearsUpdate next due date 1 yearUpdate next due date 1 to 3 yearsUpdate next due date 5 yearsUpdate next due date 5 yearsendyesnoyesnoyesnoyesnoyesno

Semi-Structured Logic Statements

Inclusions

NameDescription
Patients eligible for screening
See 'Screening Eligible' logic path
Patients at average risk for colorectal cancer
See 'Increased Risk Exclusions' logic path

Exclusions

None.

Events

NameDescription
Most recent CRC screening test is colonoscopy?
Flexible sigmoidoscopy done within past 10 years?
current date minus DATE of latest 'Flexible sigmoidoscopy' is < 10 years
Most recent CRC screening test is FOBT or FIT?
Most recent CRC screening test is sDNA-FIT?
Most recent CRC screening test is CT colonography?
Most recent CRC screening test is flexible sigmoidoscopy?

Actions

Update next due date 10 years
Description

Source: USPSTF, 2021
Pseudocode
Next due date = DATE of latest 'Colonoscopy' + MIN('Recommended follow-up interval', 10 years)
Update next due date 1 year
Description
Source: USPSTF, 2021
Pseudocode
Next due date = DATE of latest 'FOBT test' + 1 year
Update next due date 1 to 3 years
Description
Source: USPSTF, 2021
Pseudocode
Next due date range = [DATE of latest 'Stool DNA-FIT test' + 1 year, DATE of latest 'Stool DNA-FIT test' + 3 years]
Update next due date 5 years
Description
Source: USPSTF, 2021
Pseudocode
Next due date = DATE of latest 'CT colonography' + 5 years
Update next due date 5 years
Description
Flex sig interval can be extended to 10 years if annual FIT is performed
Source: USPSTF, 2021
Pseudocode
Next due date = DATE of latest 'Flexible sigmoidoscopy' + MIN('Recommended follow-up interval', 5 years)

References

  • USPSTF (2021): Davidson, K. W., et al. (2021). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA - Journal of the American Medical Association, 325(19), 1965-1977. https://doi.org/10.1001/jama.2021.6238

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