{ "resourceType" : "Bundle", "id" : "IncreasedRiskExclusions_FannyFamiglietti", "type" : "collection", "entry" : [{ "fullUrl" : "http://cancerscreeningcds.github.io/crcsm-cds/CarePlan/175", "resource" : { "resourceType" : "CarePlan", "id" : "175", "text" : { "status" : "generated", "div" : "

Generated Narrative: CarePlan 175

instantiatesCanonical: Increased Risk Exclusions

status: Draft

intent: Proposal

subject: Fanny Famiglietti

created: 2024-12-10 00:00:00+0000

Activities

-Reference
*Bundle: type = collection
" }, "instantiatesCanonical" : ["http://cancerscreeningcds.github.io/crcsm-cds/PlanDefinition/flow-IncreasedRiskExclusions"], "status" : "draft", "intent" : "proposal", "subject" : { "reference" : "Patient/FannyFamiglietti", "display" : "Fanny Famiglietti" }, "created" : "2024-12-10T00:00:00.0Z", "activity" : [{ "reference" : { "reference" : "RequestGroup/176" } }] } }, { "fullUrl" : "http://cancerscreeningcds.github.io/crcsm-cds/RequestGroup/176", "resource" : { "resourceType" : "RequestGroup", "id" : "176", "text" : { "status" : "generated", "div" : "

Generated Narrative: RequestGroup 176

instantiatesCanonical: Increased Risk Exclusions

status: Draft

intent: Proposal

subject: Fanny Famiglietti

action

id

FamilyHistoryIncreasedRisk

title: Family history increased risk screening/surveillance

description: For patients with a single first-degree relative (mother, father, full sibling, child) with colorectal cancer or an advanced polyp(s):\n* If relative diagnosed at >= 60 years:\n * Start screening at 40 years old. Tests and intervals are as per average risk screening recommendations.\n* If relative diagnosed at < 60 years old:\n * Start screening 10 years before relative's age at diagnosis or age 40, whichever is earlier. Repeat colonoscopy every 5 years.\n * If no significant neoplasia appears by age 60 years, can offer expanding the interval between colonoscopies.\n\nFor patients with 2 or more first-degree relatives with colorectal cancer or an advanced polyp:\n* Start screening colonoscopy 10 years before the reatives' youngest age at diagnosis or age 40, whichever is earlier. Repeat colonoscopy every 5 years.\n\nPatients with a history of potentially precancerous polyps should follow shortest interval between recommendations above and recommendations based on colonoscopy findings.

Documentations

-TypeLabelDisplayCitation
*CitationUSMSTF (2017)Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer

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

\n
*CitationACG Average Risk (2021)ACG Clinical Guidelines: Colorectal Cancer Screening 2021

Shaukat, A., et al. (2021). ACG Clinical Guidelines: Colorectal Cancer Screening 2021. American Journal of Gastroenterology, 116(3), 458-479. https://doi.org/10.14309/ajg.0000000000001122

\n
*CitationUSMSTF Follow-Up After Colonoscopy and Polypectomy (2020)Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer

Gupta, S., et al. (2020). Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 158(4), 1131–1153.e5. https://doi.org/10.1053/j.gastro.2019.10.026

\n

resource: Bundle: type = collection

" }, "instantiatesCanonical" : ["http://cancerscreeningcds.github.io/crcsm-cds/PlanDefinition/flow-IncreasedRiskExclusions"], "status" : "draft", "intent" : "proposal", "subject" : { "reference" : "Patient/FannyFamiglietti", "display" : "Fanny Famiglietti" }, "action" : [{ "id" : "FamilyHistoryIncreasedRisk", "title" : "Family history increased risk screening/surveillance", "description" : "For patients with a single first-degree relative (mother, father, full sibling, child) with colorectal cancer or an advanced polyp(s):\n* If relative diagnosed at >= 60 years:\n * Start screening at 40 years old. Tests and intervals are as per average risk screening recommendations.\n* If relative diagnosed at < 60 years old:\n * Start screening 10 years before relative's age at diagnosis or age 40, whichever is earlier. Repeat colonoscopy every 5 years.\n * If no significant neoplasia appears by age 60 years, can offer expanding the interval between colonoscopies.\n\nFor patients with 2 or more first-degree relatives with colorectal cancer or an advanced polyp:\n* Start screening colonoscopy 10 years before the reatives' youngest age at diagnosis or age 40, whichever is earlier. Repeat colonoscopy every 5 years.\n\nPatients with a history of potentially precancerous polyps should follow shortest interval between recommendations above and recommendations based on colonoscopy findings.", "documentation" : [{ "type" : "citation", "label" : "USMSTF (2017)", "display" : "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer", "citation" : "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" }, { "type" : "citation", "label" : "ACG Average Risk (2021)", "display" : "ACG Clinical Guidelines: Colorectal Cancer Screening 2021", "citation" : "Shaukat, A., et al. (2021). ACG Clinical Guidelines: Colorectal Cancer Screening 2021. American Journal of Gastroenterology, 116(3), 458-479. https://doi.org/10.14309/ajg.0000000000001122" }, { "type" : "citation", "label" : "USMSTF Follow-Up After Colonoscopy and Polypectomy (2020)", "display" : "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer", "citation" : "Gupta, S., et al. (2020). Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 158(4), 1131–1153.e5. https://doi.org/10.1053/j.gastro.2019.10.026" }], "resource" : { "reference" : "ServiceRequest/177" } }] } }, { "fullUrl" : "http://cancerscreeningcds.github.io/crcsm-cds/ServiceRequest/177", "resource" : { "resourceType" : "ServiceRequest", "id" : "177", "text" : { "status" : "generated", "div" : "

Generated Narrative: ServiceRequest 177

basedOn: Colorectal Cancer Screening Service Request

status: option

intent: Proposal

code: Increased risk screening for colorectal cancer

subject: Fanny Famiglietti

reasonCode: Family history of colorectal cancer (situation)

" }, "basedOn" : [{ "reference" : "http://cancerscreeningcds.github.io/crcsm-cds/ActivityDefinition/ColorectalCancerScreeningServiceRequest" }], "status" : "option", "intent" : "proposal", "code" : { "coding" : [{ "system" : "http://cancerscreeningcds.github.io/crcsm-cds/CodeSystem/plan-definition-action-code-system", "code" : "increasedriskscreening", "display" : "Increased risk screening for colorectal cancer" }] }, "subject" : { "reference" : "Patient/FannyFamiglietti", "display" : "Fanny Famiglietti" }, "reasonCode" : [{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "1421000119104", "display" : "Family history of colorectal cancer (situation)" }] }] } }] }