Cancer Guidelines Database

Access quality cancer guidelines from a single Canadian source

We've listed 126 guidelines under your selection of "Type of cancer". The most recent guidelines are first.

Early Detection for Colorectal Cancer: ASCO Resource-Stratified Guideline

Year: 2019
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This clinical practice guideline focuses on the early detection of colorectal cancer and the management of polyps found during colorectal cancer screening among those at average risk, as well as the workup and diagnosis of colorectal cancer. The guideline discusses the optimal strategies for population-level early detection of colorectal cancer in high-incidence and resource-constrained settings, the optimal reflex testing strategy for people with positive screening results, the optimal strategy for people with premalignant polyps or other abnormal screening results, and the optimal methods for diagnosing patients who have signs and symptoms of early colorectal cancer. Recommendations are resource-stratified and are tailored to basic, limited, enhanced and maximal resource settings.

Neuroendocrine and Adrenal Tumours, Version 4.2018

Year: 2019
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.

Endoscopic Surveillance After Surgical or Endoscopic Resection for Colorectal Cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline

Year: 2019
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
This is a clinical practice guideline for patients who have been operated on for sporadic colorectal cancer (CRC) and for those in whom a low risk T1 CRC has been completely removed at endoscopy. The guideline discusses the endoscopic surveillance of these patients, and provides recommendations on the appropriate timing of endoscopy (i.e. in specific intervals following surgery), and the age at which to halt the use of surveillance endoscopy. Outcomes of interest include overall survival, CRC-specific survival, relapse-free survival, and adverse effects.

Preoperative or Postoperative Therapy for the Management of Patients With Stage II or III Rectal Cancer

Year: 2019
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline examines the appropriate preoperative staging tests and the role of postoperative radiotherapy (RT) and/or chemotherapy (CT) for patients with resected stage II or III rectal cancer. The primary outcomes of interest are increase in overall survival and delaying local recurrence.

Evidenced-Based Guideline for Colorectal Cancer

Year: 2019
AGREE II score: Available
Developer organization: German Guideline Program in Oncology
This is a clinical practice guideline for physicians who work on the prevention and treatment of colorectal cancer in the ambulatory and inpatient sector. The guideline provides recommendations for prevention, screening in asymptomatic populations as well as high risk populations, the role of endoscopy in the diagnosis of polyps and colorectal cancer, pre-operative diagnostics and surgery, adjuvant and neoadjuvant therapy, management of patients with metastases, palliative care and follow-up care.

Metastatic Colorectal Cancer

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with metastatic colorectal cancer. The guideline examines treatment options, including different chemotherapy regimens, and metastasectomy. Other topics of discussion include palliative chemotherapy regimens, and treatment of liver metastasis. Outcomes of interest include adverse effects, overall survival, and quality of life.

Colon Cancer, Version 4.2018

Year: 2018
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for the management of colon cancer. Recommendations are made for diagnosis, pathologic staging, surgical management, perioperative treatment, surveillance, and management of recurrence. Principles for the management of metastatic disease are also provided.

Colorectal Cancer Screening, Version 1.2018

Year: 2018
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline discussing colorectal cancer (CRC) screening in adults. Recommendations are made for three groups of patients, stratified by their risk of developing CRC: average risk, increased risk, and high risk syndromes. Screening modalities examined include structural screening tests, such as colonoscopy, flexible sigmoidoscopy, and computed tomographic colonography, as well as fecal-based tests, which include fecal occult blood test, and combined stool deoxyribonucleic acid/fecal immunochemical (DNA/FIT) tests.

Colon Cancer, Version 2.2018

Year: 2018
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for the management of colon cancer. Recommendations are made for diagnosis, pathologic staging, surgical management, perioperative treatment, surveillance, and management of recurrence. Principles for the management of metastatic disease are also provided.

ACR Appropriateness Criteria Colorectal Cancer Screening

Year: 2018
AGREE II score: Available
Developer organization: American College of Radiology
This is a clinical practice guideline for individuals with average, moderate, or high risk of developing colorectal cancer. The guideline the examines the appropriateness of various screening procedures including computed tomography (CT) colonography, X-ray barium enema double-contrast, magnetic resonance colonography, and X-ray barium enema single-contrast. The guideline also considers age, family medical history of colorectal cancer, and presence of other conditions or risk factors.

Recommendations for Filgrastim Use in Adults by Disease Site

Year: 2018
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.

The Role of Primary Tumour Location in the Selection of Biologics for the Treatment of Unresectable Metastatic Colorectal Cancer: An Endorsement of a Canadian Consensus Statement

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with RAS wild-type unresectable metastatic colorectal cancer (mCRC) who are undergoing first-line or second-line chemotherapy. The guideline provides recommendations on the role of primary tumour location (PTL) in the selection of epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) and vascular endothelial growth factor (VEGF) inhibitors, in addition to chemotherapy for the treatment of unresectable mCRC.

Rectal Cancer, Version 3.2018

Year: 2018
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for the management of rectal cancer. The guideline provides recommendations regarding diagnosis, pathologic staging, surgical management, perioperative treatment, management of recurrent and metastatic disease, and patient surveillance. Outcomes of interest include safety and efficacy of treatment, adverse outcomes, and overall survival.

Clinical Practice Guideline on Screening for Colorectal Cancer in Individuals With a Family History of Nonhereditary Colorectal Cancer or Adenoma: The Canadian Association of Gastroenterology Banff Consensus

Year: 2018
AGREE II score: Available
Developer organization: Canadian Association of Gastroenterology
This is a clinical practice guideline for adults with a family history of nonhereditary colorectal cancer (CRC) or adenoma. The guideline discusses screening for CRC in these individuals, and provides specialized recommendations based on the number of affected relatives, whether or not the relatives have CRC or colorectal adenoma, the severity of the relatives' disease, as well as how related the relatives are to the patient (i.e. first degree versus second degree relatives).

Neuroendocrine and Adrenal Tumors, Version 2.2018

Year: 2018
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.

Rectal Cancer, Version 2.2018

Year: 2018
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for the management of rectal cancer. The guideline provides recommendations regarding diagnosis, pathologic staging, surgical management, perioperative treatment, management of recurrent and metastatic disease, and patient surveillance. Outcomes of interest include safety and efficacy of treatment, adverse outcomes, and overall survival.

Referral of Patients With Suspected Colorectal Cancer by Family Physicians and Other Primary Care Providers

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on the referral of patients with signs and/or symptoms of colorectal cancer (CRC) by family physicians and other primary care providers. The guideline reviews signs, symptoms, and other clinical features that may be indicative of CRC and that warrant additional investigation. Referral wait time recommendations are provided, along with recommendations to reduce diagnostic delay. Additionally, known risk factors that increase the likelihood of CRC in patients with signs and/or symptoms of CRC are reviewed.

Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes

Year: 2017
AGREE II score: Unavailable
Developer organization: American Society of Colon and Rectal Surgeons
This is a clinical practice guideline for men and women with inherited polyposis syndromes. The guideline examines the identification and management of familial adenomatosis polyposis (FAP), attenuated FAP, MutY homologue-associated polyposis (MAP), and polyposis without an identified genotype. Extraintestinal manifestations included in the adenomatous polyposis syndromes are also discussed.

Recommendations for Reporting Tumor Budding in Colorectal Cancer Based on the International Tumor Budding Consensus Conference (ITBCC) 2016

Year: 2017
AGREE II score: Unavailable
Developer organization: United States and Canadian Academy of Pathology
This is a clinical practice guideline for patients with colorectal cancer. The guideline examines tumour budding as a prognostic factor in these patients. The definition of tumour budding, clinical scenarios and tumour budding, H&E and immunohistochemistry for the tumour budding score, intratumoural and peritumoural budding, field number and size for the tumour budding score, cut-offs and continuous scale for the tumour budding score, and reporting tumour budding are all discussed.

Recommendations on Fecal Immunochemical Testing to Screen for Colorectal Neoplasia: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: American Society for Gastrointestinal Endoscopy
This is a clinical practice guideline on the use of fecal immunochemical testing (FIT) in colorectal cancer screening. Guidance is provided on the application of FIT and FIT-based screening programs, including recommendations on the number of tests, screening intervals and cut-off values. The guideline also compares the effectiveness of FIT relative to other colorectal screening tests. Outcomes of interest include sensitivity, specificity and adherence rates.

Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer

Year: 2017
AGREE II score: Available
Developer organization: The US Multi-Society Task Force on Colorectal Cancer
This is a clinical practice guideline for the screening of colorectal cancer. Recommendations are provided for specific screening tests, and for the various approaches used to determine when and to whom screening should be offered. Screening tests discussed include colonoscopy, fecal immunochemical test, and computed tomography (CT) colonography. Cost issues, quality of screening, practical considerations, and family history are also discussed.

Genetic/Familial High-Risk Assessment: Colorectal

Year: 2017
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for the assessment of patients who are at high risk for colorectal cancer due to genetic or familial factors. The guideline provides recommendations for the management of patients with high-risk syndromes, including Lynch syndrome, familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome (PJS), Juvenile Polyposis Syndrome (JPS), Serrated Polyposis Syndrome (SPS), and other high-risk syndromes associated with colorectal cancer risk.

Early Stage Colon Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with early stage colon cancer. The guideline discusses diagnostic work-up, staging, and treatment options. Recommendations for adjuvant chemotherapy are presented, based on cancer stage.

Recommendations on Surveillance and Management of Biallelic Mismatch Repair Deficiency (BMMRD) Syndrome: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: The US Multi-Society Task Force on Colorectal Cancer
This is a consensus statement providing recommendations to assist health care providers with the appropriate management of patients with biallelic mismatch repair deficiency (BMMRD) syndrome, also called constitutional mismatch repair deficiency syndrome. The guideline outlines what is known about BMMRD, the unique genetic and clinical aspects of the disease, and reviews the current management approaches taken.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Dihydropyrimidine Dehydrogenase Genotype and Fluoropyrimidine Dosing: 2017 Update

Year: 2017
AGREE II score: Available
Developer organization: Clinical Pharmacogenetics Implementation Consortium
This is a clinical practice guideline for patients with colorectal cancer, breast cancer, or cancers of the aerodigestive tract, who are being considered for treatment with fluoropyrimidines (5-fluorouracil and capecitabine). The guideline provides recommendations for the interpretation of clinical dihydropyrimidine dehydrogenase (DPYD) genotype tests so that the results can be used to guide fluoropyrimidine dosage. The primary outcome of interest is reduced toxicity among individuals with subnormal DPYD metabolism.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Colon Cancer

Year: 2017
AGREE II score: Available
Developer organization: American Society of Colon and Rectal Surgeons
This is a clinical practice guideline for patients diagnosed with colon cancer. The guideline examines the evaluation, staging, and treatment of these patients. Surgical treatment of the primary tumour is discussed, as well as treatment of tumour-related emergencies, management of stage 4 disease, management of locoregional recurrence, documentation, and adjuvant therapy.

Clinical Practice Guidelines for the Surgical Treatment of Patients With Lynch Syndrome

Year: 2017
AGREE II score: Unavailable
Developer organization: American Society of Colon and Rectal Surgeons
This is a clinical practice guideline for patients with Lynch syndrome (LS). The guideline examines screening, prevention, and treatment of cancer in these patients. Specifically, screening tests for endometrial, ovarian, gastric, small intestinal, pancreatic, breast, and prostate cancers, as well as cancers of the urinary tract, are discussed. Prophylactic hysterectomy and oophorectomy, tumour testing, germline testing, and LS management are also examined.

Colorectal Polypectomy and Endoscopic Mucosal Resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE)

Year: 2017
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
This is a clinical practice guideline for patients with colorectal polyps. The guideline examines the use of polypectomy and endoscopic mucosal resection (EMR) in colonoscopy and for colorectal cancer (CRC) prevention. Polyp classification, polypectomy for polyps smaller than 20mm, EMR for polyps 20mm or larger, technical considerations, adverse events, and histopathology are discussed.

Molecular Biomarkers for the Evaluation of Colorectal Cancer: Guideline From the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and the American Society of Clinical Oncology

Year: 2017
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This clinical practice guideline focuses on molecular biomarker testing for patients with early and advanced colorectal cancer. The recommendations are intended to help establish standard molecular biomarker testing, guide decisions on whether or not to use epidermal growth factor receptor (EGFR)-targeted therapy, and to ensure that the most effective and advance personalized care is delivered to patients.

Tobacco Screening and Treatment for Adult Cancer Patients

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. Recommendations are provided on implementation of the brief tobacco intervention using the evidence-based AAR Brief Tobacco Intervention Model which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. The 2015 guideline was revised in June 2016 to abbreviate the cessation intervention model to best support adoption across all CCA clinics and settings. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes, and the impact of tobacco use on cancer treatment is reviewed with a specific focus on erlotinib and irinotecan.

Myeloid Growth Factors – Version 2.2016

Year: 2016
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for the use of myeloid growth factors in adult patients with solid tumours and non-myeloid malignancies. Benefits and risks are reviewed, the role of biosimilars is discussed, and recommendations are provided for prophylactic and therapeutic uses of both granulocyte and granulocyte-macrophage colony stimulating factors (CSFs). Recommendations are also given regarding the use of CSFs in the hematopoietic cell transplant setting. Outcomes of interest include efficacy of CSFs, mortality, length of hospitalization, toxicity, and adverse effects.

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

Year: 2016
AGREE II score: Available
Developer organization: United States Preventive Services Task Force
This is an update to the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer. The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality. Other topics discussed in the guideline include: the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps; as well as information on optimal starting and stopping ages and screening intervals across the different available screening methods.

Metastatic Colorectal Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the treatment of adult patients with metastatic colorectal cancer. The guideline examines different management options, including treatment via clinical trials, treatment chemotherapy, palliative chemotherapy, EGFR inhibitors, and regorafenib (as a fourth-line therapy). The guideline also discusses the need to test for Ras mutations before treatment. Outcomes of interest include treatment efficacy and improved survival outcomes.

Guidelines for the Investigation of Patients With Symptoms Suggestive of Colorectal Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline for adult patients in primary care settings or emergency departments who have signs and symptoms suggestive of colorectal cancer (CRC). The guideline examines how to define expectations for primary care providers (PCPs), endoscopists, and radiologists regarding the appropriate work up of patients who have symptoms suggestive of colorectal cancer, and outlines the communication expectations between PCPs, endoscopists, radiologists, and other health care providers and patients. Outcomes of interest include effective communication, as well as early and accurate diagnoses.

Rectal Cancer – Version 2.2016

Year: 2016
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with colon cancer. The guideline reviews risk assessment, TNM staging, and pathology, and provides recommendations on the clinical presentation and treatment of nonmetastatic disease as well as recommendations on management of metastatic disease. Treatment for locally recurrent disease and survivorship are also discussed, as is the role of vitamin D in colorectal cancer.

Palliative Radiotherapy: Bleeding and Gastrointestinal Obstruction

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for palliative oncology patients 18 years of age or older with low grade/ low volume/ malignancy-associated urogenital or gastrointestinal bleeding, or with malignant gastrointestinal obstruction, compression or invasion. External beam radiotherapy (EBRT) with or without , brachytherapy, stent placement, and surgical bypass are discussed as therapeutic options. Outcomes of interest include clinical improvement of symptoms, quality of life, and survival.

Colon Cancer – Version 2.2016

Year: 2016
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with colon cancer or adenocarcinomas of the small bowel and appendix. The guideline reviews staging, pathology, clinical presentation and treatment of nonmetastatic disease, management of metastatic disease, post-treatment surveillance, and survivorship. The role of vitamin D in colorectal cancer is also discussed.

Optimization of Surgical and Pathological Quality Performance in Radical Surgery for Colon and Rectal Cancer: Margins and Lymph Nodes

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for the staging and treatment of colorectal cancer. The guideline focuses on surgical and pathological considerations for the resection of colorectal cancer and provides recommendations on the technique and extent of resection, as well as the reporting of resection results. Outcomes of interest include overall survival, disease-free survival, recurrence rates, and margin status.

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

Year: 2016
AGREE II score: Available
Developer organization: United States Preventive Services Task Force
This is a clinical practice guideline for the screening of colorectal cancer in asymptomatic adults. The guideline discusses colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test as methods of screening. Outcomes of interest include reductions in all-cause mortality, mortality from colorectal cancer, and incidence of colorectal cancer. Screening intervals, age of initiation, and age of termination are determined for different screening methods, via a modeling approach.

Colorectal Cancer Screening Version – 1.2016

Year: 2016
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients at average or increased risk of developing sporadic colorectal cancer (patients with high risk colorectal cancer syndromes are not discussed). The guideline discusses risk assessment and provides recommendations for screening modality and schedule stratified by risk. Patients with increased risk include those with a personal history of adenomatous or sessile serrated polyps, colorectal cancer, inflammatory bowel disease, and/or positive family history of colorectal cancer. Screening tests include colonoscopy, flexible sigmoidoscopy computed tomographic colonography, and fecal-based screening.

Fertility Drugs and Cancer: A Guideline

Year: 2016
AGREE II score: Unavailable
Developer organization: American Society for Reproductive Medicine
This clinical practice guideline examines the impact of fertility drugs on the risk of cancer in women. The guideline looks at the association between use of fertility drugs and increased risk of developing invasive ovarian, breast, endometrial, colon and thyroid cancers as well as non-Hodgkin lymphoma and malignant melanoma. The association between fertility drugs and borderline ovarian tumours is also examined.

Recommendations on Fecal Immunochemical Testing to Screen for Colorectal Neoplasia: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer

Year: 2016
AGREE II score: Available
Developer organization: US Multi-Society Task Force on Colorectal Cancer
This guideline provides recommendations on fecal immunochemical testing (FIT) in screening for colorectal neoplasia. The guideline summarizes current evidence for FIT in colorectal neoplasia detection and the comparative effectiveness of FIT relative to other common screening modalities. Guidance statements on FIT application are developed and quality metrics for program implementation are proposed.

ACR Appropriateness Criteria Pretreatment Staging of Colorectal Cancer

Year: 2016
AGREE II score: Available
Developer organization: American College of Radiology
This is a clinical practice guideline for the pretreatment staging of colorectal cancer. Recommendations are made with consideration of two different variants of colorectal cancer: 1. rectal cancer, locoregional staging, and 2. colorectal cancer, staging for distant metastases. The guideline provides recommendations as to the appropriate imaging modalities to be used in the initial staging of colorectal cancer.

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement

Year: 2016
AGREE II score: Available
Developer organization: United States Preventive Services Task Force
This is an update to the 2009 recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal anti-inflammatory drug use to prevent colorectal cancer (CRC). The recommendations apply to adults aged 40 years or older without known CVD and without increased bleeding risk. Recommendations include consideration of the aspirin dosage as well as the benefits and harms of initiating aspirin use.

Recommendations on Screening for Colorectal Cancer in Primary Care

Year: 2016
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
This is a clinical practice guideline for asymptomatic adults aged 50 years and older who are not at high risk for colorectal cancer. The guideline provides screening recommendations stratified by age group (aged 50-74, and 74 and older). Various screening procedures are discussed and compared including fecal occult blood testing (gFOBT), fecal immunochemical testing, flexible sigmoidoscopy, and colonoscopy. Outcomes of interest include mortality and morbidity, adverse outcomes of screening procedures, test sensitivity and specificity, and positive and negative predictive values.

Colonoscopy Surveillance after Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: American Society for Gastrointestinal Endoscopy
This is a clinical practice guideline for the surveillance of patients after colorectal cancer (CRC) resection with curative intent. This guideline focuses on the role of colonoscopy in patients after CRC resection. It also considers the possible adjunctive roles of fecal testing and CTC. Overall, the goal of the guideline is to provide recommendations regarding the role of colonoscopy, flexible sigmoidoscopy, EUS, fecal testing, and CTC in surveillance after surgical resection of CRC.

Genetic/Familial High-Risk Assessment: Colorectal – Version 2.2016

Year: 2016
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This clinical practice guideline provides recommendations on colorectal screening for patients with high-risk syndromes of inherited colon cancer. Recommendations are provided for management of Lynch syndrome, FAP, MAP, Peutz-Jeghers syndrome, juvenile polyposis syndrome (JPS), SPS, and other high-risk syndromes associated with CRC risk (Li-Fraumeni syndrome [LFS] and Cowden syndrome/PTEN hamartoma tumor syndrome [PHTS]). Topics of discussion include risk assessment and genetic counselling, diagnosis, and preventative treatment options.

Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations for follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer. The guideline addresses the following questions which include: what evaluations (e.g., colonoscopy, computed tomography [CT], carcinoembryonic antigen [CEA], liver function, complete blood count [CBC], chest x-ray, history, physical exam) should be performed for surveillance for recurrence of cancer? What is a reasonable frequency of these evaluations for surveillance? Which symptoms and/or signs potentially signify a recurrence of CRC and warrant investigation?

Colon Cancer, Version 1.2016

Year: 2015
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with colon cancer or adenocarcinomas of the small bowel and appendix. The guideline reviews staging, pathology, clinical presentation and treatment of nonmetastatic disease, management of metastatic disease, post-treatment surveillance, and survivorship. The role of vitamin D in colorectal cancer is also discussed.

American Gastroenterological Association Institute Guideline on the Diagnosis and Management of Lynch Syndrome

Year: 2015
AGREE II score: Available
Developer organization: American Gastroenterological Association
This clinical practice guideline provides recommendations on the diagnosis of Lynch syndrome in patients without a personal history of colorectal or another cancer but with a family history suggestive of Lynch syndrome, as well as for patients with colorectal cancer with IHC absent for MLH1. Management of the risk of colorectal cancer for patients with Lynch syndrome is also discussed with a review of surveillance colonoscopy and recommendations on the use of aspirin as a preventative measure for cancer. Outcomes of interest include sensitivity, specificity, false-positive and false-negative rates of diagnostic tests, as well as psychological distress/quality of life, colorectal cancer incidence, staging, and mortality, Lynch-syndrome associated cancer incidence and mortality, surgical complications from colonoscopy, and costs.

Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline is for the treatment of patients with stage II and III colon cancer who have undergone complete resection with curative intent. The guideline examines the impact of different adjuvant chemotherapy regimens. Outcomes of interest include overall survival, disease-free survival, adverse events, and quality of life.

Provincial Consensus on Diagnostic and Treatment Recommendations for the Management of Rectal Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This clinical practice guideline provides recommendations on the diagnosis and treatment of rectal cancer in adult patients. Imaging procedures for staging are discussed with comparisons made between ultrasound, MRI, and CT scan. Treatment options include neoadjuvant and adjuvant chemotherapy as well as rectal cancer surgery, specifically total mesorectal excision (TME). Surgical management of recurrent rectal adenocarcinoma is also discussed.

American Cancer Society Colorectal Cancer Survivorship Care Guidelines

Year: 2015
AGREE II score: Available
Developer organization: American Cancer Society
This is a clinical practice guideline for colorectal cancer (CRC) survivors. The guideline reviews methods to identify and manage any physical and psychosocial long-term and late effects of CRC and its treatment, recommendations on surveillance for recurrence and screening for second primary cancers, and health promotion recommendations with detailed discussion about obesity, physical activity, nutrition, and smoking cessation. The guideline also discusses coordination of care among specialists and primary care providers.

Metastatic Colorectal Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult patients with metastatic colorectal cancer. The guideline examines treatment, primarily though palliative chemotherapy regimens. Outcomes of interest include delayed disease progression through monoclonal antibodies and improved treatment planning through the identification of RAS testing.

Rectal Cancer, Version 1.2016

Year: 2015
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with colon cancer. The guideline reviews risk assessment, TNM staging, and pathology, and provides recommendations on the clinical presentation and treatment of nonmetastatic disease as well as recommendations on management of metastatic disease. Treatment for locally recurrent disease and survivorship are also discussed, as is the role of vitamin D in colorectal cancer.

Early Rectal Cancer: The European Association for Endoscopic Surgery (EAES) Clinical Consensus Conference

Year: 2015
AGREE II score: Available
Developer organization: European Association for Endoscopic Surgery
This is a clinical practice guideline for patients with early rectal cancer. The guideline provides recommendations on diagnosis, staging, and treatment. Local excision, rectal resection, and total mesorectal excision are discussed as surgical options, and laparoscopic and open approaches to abdominal surgery are compared. The use of neoadjuvant (chemo) radiation therapy is also discussed. Outcomes of interest include diagnostic accuracy, sensitivity, and specificity of diagnostic and staging procedures, local recurrence, survival (5-year, overall, disease free), distant metastases rate, morbidity, and quality of life.

Genetic/Familial High-Risk Assessment: Colorectal, Version 2.2015

Year: 2015
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This clinical practice guideline provides recommendations on colorectal screening for patients with high-risk syndromes of inherited colon cancer. Recommendations are provided for management of Lynch syndrome, FAP, MAP, Peutz-Jeghers syndrome, juvenile polyposis syndrome (JPS), SPS, and other high-risk syndromes associated with CRC risk (Li-Fraumeni syndrome [LFS] and Cowden syndrome/PTEN hamartoma tumour syndrome [PHTS]). Topics of discussion include risk assessment and genetic counselling, diagnosis, and preventative treatment options.

SCENIC International Consensus Statement on Surveillance and Management of Dysplasia in Inflammatory Bowel Disease

Year: 2015
AGREE II score: Available
Developer organization: American Society for Gastrointestinal Endoscopy
A clinical practice guideline for the surveillance and management of patients with dysplasia in inflammatory bowel disease at risk of developing colorectal cancer. The guideline examines appropriate colonoscopy procedures, predominantly chromoendoscopy, and management through the resection of lesions. Outcomes of interest include increased surveillance and detection through high definition colonoscopies.

ACG Clinical Guideline: Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)

Year: 2015
AGREE II score: Unavailable
Developer organization: American College of Gastroenterology
A clinical practice guideline for the screening, diagnosis, and management of colon ischemia associated with colorectal cancer. The guideline examines appropriate CT or MRI imaging, colonoscopic diagnosis, and severity-based treatments including surgical intervention and antimicrobials. Outcomes of interest include decreased bacterial translocations and improved assessment of surgical risk.

Panitumumab And Cetuximab Toxicity Management Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with advanced colorectal cancer. The guideline reviews the safe administration of Panitumumab or Cetuximab (anti-EGFR therapy). Monitoring and treatment of adverse treatment effects are reviewed, including cutaneous toxicities, diarrhea, hypomagnesemia, fatigue, asthenia, lethargy, or malaise, hypersensitivity reactions, and interstitial lung disease.

Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This guideline provides recommendations on the use of advanced practice nurses (APNs) to optimize patient, provider, and health system outcomes across the cancer care continuum. Specifically, the guideline reviews patient populations and situations (types of needs, practice settings, phase of the cancer care continuum) for which APN roles have demonstrated equivalent or improved outcomes, or reduced harms in cancer care. Outcomes of interest include quality of life, physical, functional, psychosocial, and mental health, as well as morbidity, mortality, symptom management, patient and provider satisfaction, health care utilization, costs, and quality of care.

Tobacco Screening And Treatment For Adult Cancer Patients

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. The guideline provides recommendations on implementation of the brief tobacco intervention, using the evidence-based 5 A’s model (ASK, ADVISE, ASSESS, ASSIST, ARRANGE) which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes. The impact of tobacco use on cancer treatment is also reviewed with a specific focus on erlotinib and irinotecan.

Third-Line Treatment of Stage IV or Advanced, Unresectable Colorectal Carcinoma with Cetuximab

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with stage IV or advanced, unresectable colorectal carcinoma. The guideline examines the use of cetuximab as a third-line therapy once other therapies, including fluoropyrimidines, oxaliplatin, or irinotecan, had been tried or when patients are intolerant to other options. Outcomes of interest include progression-free and overall survival.

JGES Guidelines for Colorectal Endoscopic Submucosal Dissection/Endoscopic Mucosal Resection

Year: 2015
AGREE II score: Unavailable
Developer organization: Japan Gastroenterological Endoscopy Society
A clinical practice guideline for the use of colorectal endoscopic submucosal dissection and endoscopic mucosal resection in patients with colorectal cancer. The guideline examines diagnostic indications, perioperative diagnosis, treatment techniques, and postoperative care. Outcomes of interest include recurrence, curability, and delayed bleeding/perforation.

Colorectal Cancer Screening, Version 1.2015

Year: 2015
AGREE II score: Unavailable
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients at average or increased risk of developing sporadic colorectal cancer (patients with high risk colorectal cancer syndromes are not discussed). The guideline discusses risk assessment and provides recommendations for screening modality and schedule stratified by risk. Patients with increased risk include those with a personal history of adenomatous or sessile serrated polyps, colorectal cancer, inflammatory bowel disease, and/or positive family history of colorectal cancer. Screening tests include colonoscopy, flexible sigmoidoscopy computed tomographic colonography, and fecal-based screening.

Suspected Cancer: Recognition and Referral

Year: 2015
AGREE II score: Available
Developer organization: National Institute for Health and Care Excellence
This is a clinical practice guideline for patients of all age groups suspected of having cancers including lung and pleural, upper gastro-intestinal, lower gastrointestinal, breast, gynecological, urological, skin, head and neck, brain and central nervous system, haematological, sarcomas, and childhood cancers. Recommendations are provided on recognition and referral or investigations of cancer in primary care. Outcomes of interest include quality of life, sensitivity and specificity of diagnostic tests and signs/symptoms, positive and negative predictive values of diagnostic tests and signs/symptoms, and cost effectiveness.

Practice Guideline for the Surveillance of Patients After Curative Treatment of Colon and Rectal Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: American Society of Colon and Rectal Surgeons
This is a clinical practice guideline for the surveillance of patients after curative treatment of colon and rectal cancer. The guideline outlines different surveillance schedules, and offers recommendations for surveillance based on factors including: underlying risk for recurrence, patient comorbidity, and the ability to tolerate major surgery to resect recurrent disease or palliative chemotherapy, performance status, physiologic age, preference, and compliance.

The Role of Endoscopy in Inflammatory Bowel Disease

Year: 2015
AGREE II score: Unavailable
Developer organization: American Society for Gastrointestinal Endoscopy
This clinical practice guideline discusses the use of endoscopy for the evaluation and management of inflammatory bowel disease (IBD), with a review of endoscopic approaches for general management of IBD and recommendations for screening and surveillance of colorectal cancer. Timing of screening colonoscopy and surveillance intervals are reviewed, and surveillance procedures are discussed with comparisons made between random biopsies, white light biopsy, and surface chromoendoscopy. The guideline also provides recommendations on the management of abnormal findings including endoscopically visible lesions and dysplasia. Additional topics of interest include pouch surveillance and stricture evaluation and dilation.

Evidence-Based Clinical Practice Guidelines for Management of Colorectal Polyps

Year: 2015
AGREE II score: Available
Developer organization: The Japanese Society of Gastroenterology
This is a clinical practice guideline for management of colorectal polyps. In recognizing an increase in the morbidity of colorectal polyp in Japan, this guideline seeks to provide recommendations for endoscopic management and surveillance after treatment. Guideline developers created a number of clinical questions and statements for the current concept and diagnosis/treatment of various colorectal polyps including epidemiology, screening, pathophysiology, definition and classification, diagnosis, treatment/management, practical treatment, complications and surveillance after treatment, and other colorectal lesions (submucosal tumors, non-neoplastic polyps, polyposis, hereditary tumors, ulcerative colitis-associated tumor/carcinoma).

Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for Treatment of Colorectal Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Japanese Society for Cancer of the Colon and Rectum (JSCCR)
This is a clinical practice guideline for the treatment of colorectal cancer. The overarching aim of the guideline is to provide standard treatment strategies for colorectal cancer, to eliminate treatment disparities among institutions, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding among health-care professionals and patients. Issues addressed include: surgical treatment, treatment strategies after resection, as well as palliative care options.

ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes

Year: 2015
AGREE II score: Unavailable
Developer organization: American College of Gastroenterology
This is a clinical practice guideline for patients diagnosed with or at risk of hereditary gastrointestinal cancer syndromes including lynch syndrome, familial adenomatous polyposis (FAP), attenuated familial adenomatous polyposis (AFAP), MUTYH-associated polyposis (MAP), Peutz–Jeghers syndrome, juvenile polyposis syndrome, Cowden syndrome, serrated (hyperplastic) polyposis syndrome, hereditary pancreatic cancer, and hereditary gastric cancer. The guideline reviews initial assessment, genetic testing for a germline mutation when indicated, pre- and post-test genetic counselling, and management of patients who meet clinical criteria for a syndrome as well as those with identified pathogenic germline mutations. Outcomes of interest include cancer risk, quality of life, and survival benefit from surveillance.

ACR Appropriateness Criteria Recurrent Rectal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: American College of Radiology
This is a clinical practice guideline for patients with recurrent rectal cancer. The guideline examines the appropriateness of treatment strategies including reirradiation, intraoperative radiotherapy, permanent seed implants, stereotactic body radiotherapy, and particle therapy. The effectiveness or radiation versus chemoradiation and the importance of preoperative or definitive radiation in these patients is also considered.

Advanced Imaging for Detection and Differentiation of Colorectal Neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Year: 2014
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
A clinical practice guideline for patients with suspected colorectal neoplasia. The guideline examines diagnosis and differentiation through endoscopic imaging, including virtual and conventional methods. Outcomes of interest include improved lesion characterization and improved detection of hereditary syndromes.

British HIV Association Guidelines for HIV-Associated Malignancies 2014

Year: 2014
AGREE II score: Available
Developer organization: British HIV Association
This is a clinical practice guideline for the diagnosis and treatment of cancer and associated malignancies in adult patients with HIV. The guideline examines the most common HIV associated cancers, Kaposi sarcoma, high grade B-cell non-Hodgkin lymphoma and invasive cervical cancer, as well as a number of other cancers with higher risk profiles in HIV patients. Outcomes of interest include improved treatment options in consideration of HAART and increased prophylactic options in low-risk patients, specifically with regards to lifestyle changes and vaccinations.

Optimization of Preoperative Assessment in Patients Diagnosed with Rectal Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with rectal cancer who are newly diagnosed. The guideline provides recommendations on investigations to assess for metastases and synchronous lesions, imaging for local staging, optimal MRI protocol and criteria for local staging, optimal MRI criteria to select patients for neoadjuvant therapy, the role of multidisciplinary cancer conferences and the role of restaging MRI after neoadjuvant therapy.

Hereditary Colorectal Cancer Syndromes: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the Familial Risk–Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guidelines

Year: 2014
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This is a clinical practice guideline endorsement for people at risk for hereditary colorectal cancer (CRC) syndromes. The guideline provides recommendations on prevention, screening, genetics, treatment, and management. Topics of interest addressed in the guideline include: tumour testing for DNA mismatch repair (MMR) deficiency, genetic testing for Lynch syndrome, as well as follow-up recommendations in mutation carriers.

Saudi Oncology Society Clinical Management Guideline Series: Colorectal Cancer 2014

Year: 2014
AGREE II score: Unavailable
Developer organization: Saudi Oncology Society
This is a clinical practice guideline for the pre-treatment evaluation, staging, and treatment of colorectal cancer. Topics addressed in the guideline include an overview of surgical pathology report requirements; as well as treatment options for clinically localized resectable colon cancer, clinically localized resectable rectal cancer, and locally advanced unresectable or metastatic colon or rectal cancer.

Saudi Oncology Society Clinical Management Guideline Series: Gastric Cancer 2014

Year: 2014
AGREE II score: Unavailable
Developer organization: Saudi Oncology Society
A clinical practice guideline for patients with esophagogastric junction tumour. The guideline examines staging, pre-treatment evaluation, treatment through surgery and adjuvant therapy, and basic follow-up. Important aspects include surgical pathology report requirements and post-operative management.

Required Reports for Referrals

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on required reports for referrals for: breast, gastrointestinal (esophagus, stomach, colon-rectum, anus, pancreas, liver, biliary tract/gall bladder), genitourinary (testis, prostate, bladder), gynecology (endometrium, cervix, ovary, vulva & vagina), head and neck (parotid & submandibular gland, thyroid, mouth, palate, nasopharynx, oropharynx, hypopharynx, nose & antrum, ear), lung, lymphoma and leukemia, melanoma, musculoskeletal and sarcoma, neuro-oncology, primary unknown, and skin (basal cell & squamous cell carcinomas, mycosis fungoides – Sezary syndrome). The guideline provides recommendations on pathology reports, operative reports, laboratory reports, and imaging reports. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Anal Cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up

Year: 2014
AGREE II score: Unavailable
Developer organization: European Society for Medical Oncology
This is a clinical practice guideline for patients diagnosed with or at risk of having anal cancer. The guideline outlines screening and prevention, diagnostic assessment and staging, treatment, and follow-up and surveillance. Special topics of interest include treatment of the elderly and personalized medicine. Management of advanced/metastatic disease is also discussed. Outcomes of interest include survival, recurrence rates and quality of life.

Guidelines on Genetic Evaluation and Management of Lynch Syndrome: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: American College of Gastroenterology
This is a clinical practice guideline for patients at risk for and affected with Lynch syndrome. The guideline examines appropriate provision of genetic testing and management of patients. Important aspects include: ways to assess individuals for the risk of colorectal cancer, tumour testing, algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome, and the provision of diagnosis and management strategies to health-care providers caring for these patients.

Colorectal Cancer: The Diagnosis and Management of Colorectal Cancer – Addendum to Clinical Guideline 131

Year: 2014
AGREE II score: Available
Developer organization: National Institute for Health and Care Excellence
A clinical practice guideline for acute bowel obstruction caused by colorectal cancer and patients with early stage rectal cancer. The guideline examines the efficacy of stenting and bowel resection as an alternative to emergency procedures, and less invasive treatments, including transanal endoscopic microsurgery, as first-line treatment for early stage cancer. Outcomes of interest include reduced hospital stay and improved bowel function.

Metastatic Colorectal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with metastatic colorectal cancer. The guideline reviews surveillance and treatment options including surgery, radiotherapy, palliative chemotherapy and biological therapy. Outcomes of interest include survival (overall, progression-free), and toxicity.

Colorectal Cancer Screening Clinical Practice Guideline

Year: 2014
AGREE II score: Available
Developer organization: Kaiser Permanente
This clinical practice guideline addresses colorectal cancer screening for asymptomatic adults, in the primary care setting. Risk factors and screening test effectiveness are discussed and recommendations are provided based on age and risk. Outcomes of interest include colon cancer incidence, morbidity, and mortality, as well as outcomes of screening intervention including test effectiveness and adverse effects.

Strategies of Sequential Therapies in Unresectable, Metastatic Colorectal Cancer Treated With Palliative Intent

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients (18 years or older) with unresectable metastatic colorectal cancer. The guideline provides recommendations on sequential chemotherapy strategies for treatment with palliative intent. The cytotoxic agents discussed include initial fluoropyrimidine (5-FU or capecitabine) either alone or in combination, irinotecan and oxaliplatin. Outcomes of interest are overall survival, toxicity, and quality of life.

Gastrointestinal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on gastrointestinal cancer, with sub-sections discussing the following tumour sites: anus, bile duct, colon, esophageal and esophagogastric junction, gallbladder, liver, neuroendocrine tumours, lymphoma, gastro-intestinal stromal tumours (GIST), pancreas, rectum, small bowel, and stomach. Important aspects discussed in the guideline include: screening, diagnostic and staging, surgical therapy, staging, follow up and surveillance, and considers different treatment options. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Colon Cancer: Diagnosis, Treatment and Follow-Up

Year: 2014
AGREE II score: Available
Developer organization: Belgian Health Care Knowledge Centre
This is a clinical practice guideline for adult patients diagnosed with or suspected of having colon cancer. The guideline provides recommendations on diagnostic assessment and staging, pathology, treatment, and follow-up care. The use of KRAS mutational analysis and BRAF are reviewed, and N-RAS and MSI are discussed as predictors of treatment effectiveness. Comparisons are made between chemotherapy regimes, surgical techniques, and recovery programs. Outcomes of interest include sensitivity and specificity of diagnostic tests, survival (progression-free, overall), surgical outcomes (mortality, complications, readmissions, hospital stay, peri-procedural morality), and quality of life.

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Year: 2014
AGREE II score: Available
Developer organization: US Multi-Society Task Force on Colorectal Cancer
A clinical practice guideline for adult and paediatric patients undergoing colonoscopies for cancer surveillance. The guideline examines appropriate bowel cleansing procedures, including dietary recommendations and salvage options. Outcomes of interest include improved OTC purgative prescription and greater use of low-volume agents.

Clinical Indications for Computed Tomographic Colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

Year: 2014
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
A clinical practice guideline for the use of computed tomographic colonography in patients with colorectal cancer. The guideline examines colorectal surveillance and polypectomy and their feasibility for patients with symptoms of colorectal cancers. Outcomes of interest include improvements over standard barium enemas and increased diagnostic sensitivity.

Oncogenetic Testing for Lynch Syndrome and Familial Adenomatous Polyposis

Year: 2014
AGREE II score: Available
Developer organization: Belgian Health Care Knowledge Centre
This is a clinical practice guideline for patients with colorectal cancer or for patients who are otherwise at risk of Lynch syndrome or familial adenomatous polyposis (FAP). The guideline provides recommendations on the identification and referral of patients to genetic centres for counselling, and discusses appropriate follow-up screening for Lynch syndrome and FAP. The use of Microsatellite instability (MSI) as both a predictor of treatment effectiveness and a predictor of Lynch syndrome is reviewed, with MSI compared to immunohistochemistry when screening for Lynch syndrome.

Stages II and III Colorectal Cancer Surveillance

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over the age of 18 years with stage II or III colorectal cancer. The guideline discusses follow-up care and provides recommendations regarding the timing and appropriateness of surveillance tests/procedures including CEA testing, colonoscopy, PET scans and CT scans. The guideline also discusses how physicians can educate patients about adopting healthy lifestyle behaviours to improve survival outcomes.

Self-expandable Metal Stents for Obstructing Colonic and Extracolonic Cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Year: 2014
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy
A clinical practice guideline for patients with malignant colonic obstruction and colorectal cancer. The guideline examines colonic self-expandable metal stent placement in prophylactic, elective, emergency, and palliative surgeries. Outcomes of interest include reduced colonic perforation and reduced mortality.

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Year: 2014
AGREE II score: Unavailable
Developer organization: American Society of Colon and Rectal Surgeons
This is a clinical practice guideline outlining surgical treatment options for patients with ulcerative colitis. The guideline examines indications for surgery, with a specific focus on the intractability of ulcerative colitis, as well as surgical and postoperative management. The guideline also provides recommendations for cancer screening by endoscopy for patients with long-standing ulcerative colitis. Outcomes of interest include improvements in quality of life and potential curative measures.

Continuous versus Intermittent Chemotherapy Strategies in Inoperable, Advanced Colorectal Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients (18 years or older) with inoperable, advanced (Stage IV) colorectal cancer. The guideline provides recommendations on the use of intermittent systemic treatment strategies. Outcomes of interest include overall response rate, survival (overall, progression-free, failure free), toxicity, and quality of life.

Post-Polypectomy Colonoscopy Surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Year: 2013
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
This clinical practice guideline reviews risk stratification following the removal of precancerous neoplastic lesions and provides recommendations for timing of endoscopic surveillance. Outcomes of interest include short- and long-term risk of future development of advanced neoplasia, incidence and mortality of metachronous advanced lesions, and accuracy of screening procedures.

Guideline for Colonoscopy Quality Assurance in Ontario

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A professional guideline for colonoscopy training as part of fecal occult blood test based colorectal cancer screening. The guideline examines training, competency maintenance, and quality assurance measures for colonoscopies and related patient assessment procedures. Outcomes of interest include improved auditable outcomes and clearer pre-assessment standards.

Management of the Malignant Colorectal Polyp: ACPGBI Position Statement

Year: 2013
AGREE II score: Unavailable
Developer organization: Association of Coloproctology of Great Britain and Ireland
This is a clinical practice guideline for patients with a malignant polyp. The guideline reviews topics such as colonoscopy and endoscopic technique for the removal of large adenomas, the histopathology of adenomas and polypoid carcinomas, how prognostic indicators influence the risk of residual cancer in the bowel wall or lymph nodes, and the likelihood of recurrence if additional treatment is not taken. As well, the benefits and harms of endoscopic resection are reviewed, and the role of endoscopic and radiological imaging in the assessment and follow up of malignant polyps is discussed. Outcomes of interest include risk of post-surgical morbidity and mortality, risk of recurrence, disease-specific survival, and nodal metastasis.

Follow-Up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement

Year: 2013
AGREE II score: Unavailable
Developer organization: American Society of Clinical Oncology
A clinical practice guideline for survivors of colorectal cancer. The guideline examines appropriate follow-up and surveillance for stage II and III cancer survivors, including appropriate timing, supportive care, and secondary prevention. Outcomes of interest include improved prevention through lifestyle changes and increasing carcinoembryonic antigen testing when necessary.

Provincial Colorectal Cancer Treatment Guidelines

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with colorectal cancer. The guideline examines work up steps, and includes recommendations for resectable and unresectable colon and rectal cancers. Outcomes of interest include high response rates with combination chemotherapy and improved therapies for K-RAS mutated tumours.

Colorectal Screening For Cancer Prevention in Asymptomatic Patients

Year: 2013
AGREE II score: Unavailable
Developer organization: British Columbia Medical Services Commission
This is a clinical practice guideline for asymptomatic patients over 19 years of age. The guideline provides recommendations on screening for colorectal cancer stratified by age and risk. Risk factors are discussed, and screening procedures are reviewed including fecal occult blood test (FOBT), colonoscopy, flexible sigmoidoscopy, and CT colonography.

Practice Parameters for the Management of Rectal Cancer (Revised)

Year: 2013
AGREE II score: Unavailable
Developer organization: American Society of Colon and Rectal Surgeons
A clinical practice guideline for the management of colorectal carcinoma. The guideline examines preoperative assessment, staging, surgical techniques, and operative considerations. Outcomes of interest include improved surgical management and reduced recurrence rate.

Follow-up of Colorectal Polyps or Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: British Columbia Medical Association
This is a guideline for patients who have received curative resection of colorectal cancer (CRC) or polypectomy. The guideline provides recommendations on follow-up procedures and intervals depending on risk group. Follow-up visits are outlined and procedures including colonoscopy, imaging and x-rays, tumour markers, and fecal occult blood tests are reviewed. Long-term surveillance is also discussed.

Early Stage Colon Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over 18 years of age with early stage colon cancer. The guideline provides recommendations on diagnostic work-up, staging, and treatment including a review of recommended chemotherapy regimes.

Guidelines for Breast, Cervical and Colorectal Cancer Screening

Year: 2013
AGREE II score: Unavailable
Developer organization: CancerCare Manitoba
This guideline provides screening recommendations for breast, cervical, and colorectal cancer, based on age and risk factors. Management of test results including mammography, cytology, occult blood test (FOBT) and colonoscopy are discussed, and potential benefits and harms are reviewed. Other testing procedures include ultrasound, stereotactic core biopsy, colposcopy, endocervical curettage, endometrial biopsy, flexible sigmoidoscopy, and colonoscopy.

Revised Guidelines for the Clinical Management of Lynch Syndrome (HNPCC): Recommendations by a Group of European Experts

Year: 2013
AGREE II score: Unavailable
Developer organization: Mallorca Group
This is a clinical practice guideline regarding the clinical management of Lynch syndrome (LS) (previously referred to as hereditary non-polyposis colorectal cancer; HNPCC). The guideline looks at improving the identification of LS, optimal surveillance protocols for various cancers, the role of prophylactic hysterectomy with or without oophorectomy, and appropriate surgical treatment for CRC. Other topics of discussion include the influence of lifestyle and environmental factors on the development of CRC in LS, the role of aspirin in the management of LS, prenatal diagnosis (PND) and preimplantation genetic diagnosis (PGD) in LS, and the psychosocial implications of genetic testing and surveillance.

Role of Endoscopy in the Staging and Management of Colorectal Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: American Society for Gastrointestinal Endoscopy
A clinical practice guideline for the use of gastrointestinal endoscopy in the staging and management of colorectal cancer in adult patients. The guideline examines staging, endoscopic management, and endoscopic resection in colonic obstructions and colorectal neoplasia. Outcomes of interest include improved differentiation between benign and malignant lymph nodes through endoscopic ultrasound-guided fine-needle aspiration.

Bowel Preparation for Colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Year: 2013
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
A clinical practice for patients with cervical intraepithelial neoplasia. The guideline examines the use of cryotherapy based on lesion size and other risk factors. Recommendations on technique are included, and comparisons are made to loop electrosurgical excision procedures.

Prevention and Treatment of Rash in Patients Treated with EGFR Inhibitor Therapies

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with advanced non-small cell lung cancer, colorectal cancer, head/neck cancer, or breast cancer, that is treated with the epidermal growth factor receptor (EGFR) inhibitors cetuximab, erlotinib, gefitinib, panitumumab, or lapatinib, either alone or in combination with other treatments. The guideline examines the prevention and management of a papulopustular rash that commonly develops as a side effect of EGFR inhibitor therapy. Topics of discussion include prevention and prophylactic treatment of rash, clinical management, and supportive care. Outcomes of interest include rash severity, rate of recurrence, and response to treatment.

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Year: 2012
AGREE II score: Unavailable
Developer organization: Enhanced Recovery After Surgery Group
This clinical practice guideline discusses pre- and peri-operative care interventions for patients undergoing elective rectal or pelvic surgery. Comparisons are made between rectal resection and colon resection recommendations, specifically in pre-operative counselling and optimisation. Outcomes of interest include rates of anastamotic leaks, length of hospital stay, and post-operative morbidity.

The Role of Liver Resection in Colorectal Cancer Metastases

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline reviews surgical management of patients with liver metastases from colorectal cancer who have had or will have a complete resection of the primary cancer, and who meet the surgical criteria for the resection of liver-only metastases. The guideline examines the role of liver resection in special cases of liver plus extrahepatic metastases (EHM). The use of perioperative chemotherapy is also discussed. Outcomes of interest include median survival, three- and five-year survival, recurrence rate, postoperative complications, and chemotherapy-related hepatic injury.

Referral of Patients with Suspected Colorectal Cancer by Family Physicians and Other Primary Care Providers

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical guideline examines the management of adult patients presenting in primary care settings with signs and/or symptoms of colorectal cancer. Clinical presentation (focused history and physical examination), referral, and recommendations to reduce diagnostic delay are discussed. Assessment techniques include digital rectal examination, physical examination, complete blood count (CBC), fecal occult blood test (FOBT), computed tomographic (CT) colonography and double-contrast barium enema (DCBE). Outcomes of interest are positive predictive values for colorectal cancer.

Serrated Lesions of the Colorectum: Review and Recommendations From an Expert Panel

Year: 2012
AGREE II score: Unavailable
Developer organization: Other, please specify below:
This is a clinical practice guideline for the management of patients with serrated lesions of the colorectum. The guideline reviews pathology, molecular features, epidemiology, and detection of lesions and provides recommendations regarding removal of lesions and post-polypectomy surveillance. Serrated polyposis syndrome (SPS) is also discussed.

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Year: 2012
AGREE II score: Unavailable
Developer organization: Enhanced Recovery After Surgery Group
A clinical practice guideline for the perioperative care of patients undergoing elective colonic surgery. The guideline examines pre- and peri-operative nutrition and analgesic care options, as well as postoperative complication reduction options. Outcomes of interest include reduced length of hospital stay, re-admissions, and mortality.

European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis: First Edition

Year: 2012
AGREE II score: Available
Developer organization: International Agency for Research on Cancer
A clinical practice guideline for the screening and surveillance of patients at risk for colorectal cancer. The guideline examines quality assurance and professional requirements for common screening procedures, such as endoscopy and fecal occult blood tests, and including recommendations for follow-up and treatment timing. Outcomes of interest include improved safety and improved patient experience.

Quality in Screening Colonoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE)

Year: 2012
AGREE II score: Unavailable
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
This clinical practice guideline reviews the use of colonoscopy for colorectal cancer screening. The guidelines reviews colonoscopy preparation and provides recommendations for colonoscopy procedure and cleaning and disinfection of equipment. Recommendations are also made for experience of colonoscopists, recording of adverse outcomes, and the colonoscopy report. Outcomes of interest include detection rate and adverse events.

Guideline Colon Capsule Endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Year: 2012
AGREE II score: Available
Developer organization: European Society of Gastrointestinal Endoscopy (ESGE)
This clinical practice guideline reviews colon capsule endoscopy (CCE) for use in colorectal cancer screening. Indications and contraindications, bowel preparation, and reporting and workup of CCE results are discussed. Positive and negative predictive value, sensitivity, and specificity of CCE are considered.

Practice Parameters for the Management of Colon Cancer

Year: 2012
AGREE II score: Unavailable
Developer organization: American Society of Colon and Rectal Surgeons
A clinical practice guideline for patients with colon cancer. The guideline examines risk assessment and treatment, primarily through surgical resection. Outcomes of interest include improved prediction of outcomes through histologic grading and reduced surgical morbidity in palliative procedures.

Recommendations from the EGAPP Working Group: Can Testing of Tumor Tissue for Mutations in EGFR Pathway Downstream Effector Genes in Patients with Metastatic Colorectal Cancer Improve Health Outcomes by Guiding Decisions Regarding Anti-EGFR Therapy?

Year: 2012
AGREE II score: Unavailable
Developer organization: Evaluation of Genomic Applications in Practice and Prevention Working Group
This recommendation statement explores the use of pharmacogenomic testing of tumour in patients with metastatic colorectal cancer to predict response to anti-EGFR antibody therapy (cetuximab or panitumumab). The guideline reviews analytic and clinical validity of testing for selected pharmacogenomic tests including codon 12 and 13 mutations in KRAS, the BRAF V600E mutation, variants in NRAS and in PIK3CA, and loss of PTEN and AKT protein expression. Outcomes of interest include overall or progression-free survival and treatment-related adverse events.

Guidelines for Colonoscopy Surveillance After Screening and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer

Year: 2012
AGREE II score: Available
Developer organization: American Gastroenterological Association
A clinical practice guideline for colorectal cancer screening in asymptomatic patients. The guideline examines screening and surveillance intervals given the potential presence of adenomatous polyps and previous polypectomies. Outcomes of interest include colonoscopy quality and follow up surveillance procedures.

Clinical Practice Guidelines for Surveillance Colonoscopy

Year: 2011
AGREE II score: Available
Developer organization: Cancer Council Australia
This is a clinical practice guideline for patients known to be at above-average risk for colorectal cancer (CRC) development, such as patients who have already had adenomatous polyps removed or surgery for CRC and patients with inflammatory bowel disease. The guideline discusses colonoscopic surveillance after polypectomy, the role of surveillance colonoscopy after curative resection for colorectal cancer, and colonoscopic surveillance and management of dysplasia in inflammatory bowel disease. Psychosocial aspects, socio-economic factors, and economic considerations are also discussed. Outcomes of interest include adenoma detection rates, testing sensitivity, and cost effectiveness.

Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2010 for the Treatment of Colorectal Cancer

Year: 2011
AGREE II score: Unavailable
Developer organization: Japanese Society for Cancer of the Colon and Rectum (JSCCR)
This clinical practice guideline provides an overview on the treatment of colorectal cancer. Treatment strategies are outlined for all stages of colorectal cancer as well as for recurrences and hematogenous metastases, and treatment options including chemotherapy and radiotherapy are reviewed. Palliative care and surveillance after surgery are also discussed. Outcomes of interest include survival and recurrence rate.

Clinical Practice Guideline for Surveillance Colonoscopy – In Adenoma Follow-up; Following Curative Resection of Colorectal Cancer; and for Cancer Surveillance in Inflammatory Bowel Disease

Year: 2011
AGREE II score: Available
Developer organization: Cancer Council Australia
This is a clinical practice guideline for adults aged 19 and over. The guideline examines surveillance colonoscopy after polypectomy or curative resection for colorectal cancer, and in inflammatory bowel disease. Advances in colonoscopy, CT colonography, and other methods of investigation are also discussed, as well as psychosocial effects of colonoscopy and socioeconomic factors. Outcomes of interest include survival, patient experience, and accuracy of colonoscopy.

CAR CT Colonography Standards

Year: 2010
AGREE II score: Unavailable
Developer organization: Canadian Association of Radiologists
This is a clinical and professional practice guideline that recommends standards of best practice for the use of CT colonography in the screening and diagnostic assessment of colorectal cancer. The guideline discusses patient information and consent, CT technique, patient experience and safety, and interpretation of results. Additional topics include radiologist training/assessment, use of endoscopy as a post-CT test, and resource allocation.

Colorectal Cancer Screening Clinical Practice Guideline

Year: 2010
AGREE II score: Available
Developer organization: Kaiser Permanente
This is a clinical practice guideline for adults with average or high risk for colorectal cancer. The guideline discusses risk factors for colorectal cancer, effectiveness of screening tests, and screening strategies based on age and risk. The following screening techniques are compared: high-sensitivity guaiac fecal occult blood test (gFOBT), immunochemical fecal occult blood test (iFOBT/FIT), flexible sigmoidoscopy, colonoscopy, standard guaiac FOBT (gFOBT), air contrast barium enema, CT colonography, and fecal DNA testing. Outcomes of interest include colon cancer incidence, morbidity, and mortality, as well as outcomes of screening intervention including test effectiveness and adverse effects.

Colonoscopy Recommendations

Year: 2008
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline for patients requiring colon cancer screening, examining colonoscopy standards. Important aspects include ideal polyp detection conditions, monitoring during the procedure, and follow-up care.