Description

This logic path determines whether a patient should be considered for average risk colorectal cancer screening or increased risk screening or surveillance. Patients who meet criteria for higher than average risk for colorectal cancer, as defined in the U.S. Preventative Services Task Force (USPSTF), are excluded from average risk screening recommendations.

This path can be used to ensure that USPSTF average-risk recommendations are suppressed for patients meeting increased risk criteria. It can also be used to identify and surface risk factors for colorectal cancer, and to direct patients to appropriate screening/surveillance recommendations for increased risk populations.

Mid-Level Flow Diagram

Semi-Structured Logic Statements

Inclusions

Name	Description
Patients eligible for screening	Patients for whom screening is clinically appropriate.
See 'Screening Eligible' logic path

Exclusions

None.

Events

Name	Description
Personal history of or at risk for hereditary cancer syndrome?	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' OR 'Genetic marker for hereditary syndrome associated with colorectal cancer' OR 'Family history of genetic marker for hereditary syndrome associated with colorectal cancer' OR 'Family history of hereditary syndrome associated with colorectal cancer'
Personal history of inflammatory bowel disease?	A personal history of inflammatory bowel disease (ulcerative colitis or Crohn's disease)
'Personal history of inflammatory bowel disease' is TRUE
Personal history of colorectal cancer?
'Personal history of colorectal cancer' is TRUE
Family history of colorectal cancer or advanced polyp(s)?	First or second degree relative has or has had colorectal cancer.
'Family history of colorectal cancer' exists OR 'Family history of potentially precancerous polyp(s)' exists
Personal history of potentially precancerous polyp(s)?	Patient has potentially precancerous polyps.
'Personal history of potentially precancerous polyp(s)' is TRUE

Actions

Average risk screening Description Patient is eligible for colorectal screening as an average risk patient. Pseudocode See 'Average Risk Screening' logic path.

Hereditary syndromes increased risk screening/surveillance Description Patient is eligible for screening/surveillance due to having or being at risk for a hereditary cancer syndrome. Pseudocode See 'Hereditary Syndromes' logic path

IBD surveillance Description Patient is eligible for surveillance based on personal history of inflammatory bowel disease. Pseudocode See 'Inflammatory Bowel Disease' logic path.

Post-colorectal cancer resection surveillance Description Patient is eligible for surveillance after colorectal cancer resection. Pseudocode See 'Personal History of Colorectal Cancer' logic path.

Family history increased risk screening/surveillance Description Patient is eligible for increased risk screening or surveillance, considering family history of colorectal cancer and/or polyps, as well as personal history of polyps . Pseudocode See 'Family History of Colorectal Cancer or Advanced Polyps' logic path.

Post-polypectomy surveillance Description Patient is eligible for post-polypectomy surveillance recommendations. Pseudocode See 'Personal History of Potentially Precancerous Polyps' logic path.