Description
This logic path provides recommendations for colorectal cancer surveillance in individuals with hereditary syndromes which carry an increased risk of colorectal cancer.
Mid-Level Flow Diagram
Semi-Structured Logic Statements
Inclusions
| Name | Description |
|---|---|
Patients who have or are at risk for a hereditary syndrome associated with an increased risk of colorectal cancer | Patient has a clinical or genetic diagnosis of a colorectal cancer-associated hereditary syndrome, or is considered at risk for such a syndrome (e.g. suggestive family history, family history of confirmed mutation on a hereditary syndrome-associated gene). |
'Personal history of hereditary syndrome associated with colorectal cancer' is TRUE OR 'Genetic marker for hereditary syndrome associated with colorectal cancer' is TRUE OR 'Family history of genetic marker for hereditary syndrome associated with colorectal cancer' is TRUE OR 'Family history of hereditary syndrome associated with colorectal cancer' is TRUE | |
Exclusions
None.
Events
| Name | Description |
|---|---|
Personal history of Lynch syndrome, FAP, AFAP, MAP, PJS, JPS, SPS or Cowden syndrome? | Patient has a diagnosis of a hereditary syndrome associated with increased risk for colorectal cancer. |
Genetic marker for Lynch syndrome, FAP, AFAP, MAP, PJS, JPS, SPS or Cowden Syndrome? | Patient has a confirmed pathologic or likely pathologic genetic variant fpr a colorectal cancer-associated hereditary syndrome. |
Family history of genetic marker for Lynch syndrome, FAP, AFAP, MAP, PJS, JPS, or Cowden Syndrome? | Patient has a family member with a confirmed pathologic or likely pathologic genetic variant for a colorectal cancer-associated hereditary syndrome. |
Family history of SPS or familial colon cancer type X? | Patient has a family history of a syndrome not strongly associated with mutations in specific genes. |
FAMILY HISTORY of `Serrated polyposis syndrome` in `First-degree relative` EXISTS OR FAMILY HISTORY of `Familial Colorectal Cancer Type X` EXISTS | |
Actions
Recommendation: Refer to GI specialist for colonoscopy surveillance recommendations Description RECOMMENDATION: Refer to GI specialist for colorectal cancer (and possibly additional cancers) surveillance recommendations. Patients with a hereditary cancer syndrome require specialized management and colonoscopy surveillance for colorectal cancer (as well as additional surveillance for other cancers). Recommendations on when to start surveillance and surveillance intervals vary according to the syndrome. Pseudocode |
Recommendation: Colonoscopy surveillance recommendations for patients with confirmed syndrome apply Description RECOMMENDATION: Refer to GI specialist for colorectal cancer (and possibly additional cancers) surveillance recommendations. Surveillance for patients at risk for colorectal cancer hereditary syndromes is generally the same as for patients diagnosed with the syndrome. Recommendations on when to start surveillance and surveillance intervals vary according to the syndrome. Pseudocode |
References
- USMSTF (2014): Giardiello, F. M., et al. (2014). Guidelines on genetic evaluation and management of Lynch syndrome: A consensus statement by the US multi-society task force on colorectal cancer. American Journal of Gastroenterology, 109(8), 1159–1179. https://doi.org/10.1038/ajg.2014.186
- ACG (2015): Syngal, S., et al. (2015). ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes. American Journal of Gastroenterology 110(2):p 223-262. https://doi.org/10.1038/ajg.2014.435
- USMSTF (2017): Rex, D. K., et al. (2017). Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 153(1), 307–323. https://doi.org/10.1053/j.gastro.2017.05.013
- USMSTF (2022): Boland, C. R., et al. (2022). Diagnosis and Management of Cancer Risk in the Gastrointestinal Hamartomatous Polyposis Syndromes: Recommendations From the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 162(7), 2063–2085. https://doi.org/10.1053/j.gastro.2022.02.021
- NCCN (2.2024): NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric V.2.2024. https://www.nccn.org/professionals/physician_gls/pdf/genetics_ceg.pdf