Cancer Guidelines Database

This is a clinical practice guideline for adults who have been diagnosed with metastatic colorectal cancer. The guideline provides recommendations on the treatment of these patients for the purposes of improving quality of life and/or prolonging life, if possible. Multiple palliative chemotherapy regimens are discussed, as are recommendations for resecting lung and liver metastases.

This is a clinical practice guideline for adults with advanced colorectal cancer. The guideline aims to improve the quality of life for these patients by integrating an early palliative care approach into advanced cancer care. The indications for the need to apply an early, integrated palliative approach, and the essential components of such care, are specifically addressed.

This is a clinical practice guideline for adults with colorectal cancer who have developed liver metastases. The guideline examines regional therapies for the management of these patients, including conventional transarterial chemoembolization (cTACE), drug-eluting bead transarterial chemoembolization (DEB-TACE), and transarterial radioembolization (TARE). Outcomes of interest include overall survival, progression-free survival, time to progression, time to hepatic progression, overall response rate, and toxicity.

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.

This is a clinical practice guideline for adults who have undergone a colonoscopy with or without polypectomy. The guideline provides risk-stratified recommendations for the follow-up of these patients. Risk categories are based on initial colonoscopy findings, including the presence of adenomas, sessile serrated adenomas/polyps or sessile serrated polyps (SSP), hyperplastic polyps (HP), traditional serrated adenomas (TSA), or colorectal cancer (CRC).

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.

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.

This is a clinical practice guideline for patients with colorectal lesions. The guideline provides recommendations to optimize the endoscopic removal of lesions for the prevention of colorectal cancer (CRC). Specific topics addressed include lesion assessment and description, marking, surveillance after removal, and equipment considerations.

This is a clinical practice guideline for adult patients who have been diagnosed with or who are at a high risk of developing colorectal cancer (CRC). Topics examined include the prevention of CRC in patients with Lynch syndrome, management of local disease, and management of metastatic disease. Specific recommendations are provided based on disease location (e.g., the rectum or colon).

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.

This is a clinical practice guideline for patients with a higher risk of developing colorectal cancer (CRC), specifically, those with Lynch syndrome (LS) and/or familial risk of CRC. The guideline provides a framework for the endoscopic management of individuals with LS, and proposes a definition of familial risk of CRC to identify the group of individuals in whom colonoscopy surveillance is justified. Colonoscopy surveillance, quality standards, starting age, surveillance intervals and advanced imaging techniques are also addressed.

This is a clinical practice guideline for adult patients with suspected or confirmed colorectal carcinoma. Recommendations are provided for the diagnosis and treatment of these patients. Specific topics addressed include preoperative local staging, local ablation methods, and the diagnosis of distant metastases.

This is a clinical practice guideline for patients with polyposis syndromes, including familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome (PJS), juvenile polyposis syndrome (JPS), and serrated polyposis syndrome (SPS). The guideline provides recommendations on endoscopic surveillance and interventions for these patients. The primary outcomes of interest are reductions in colorectal cancer incidence and mortality.

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.

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.

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.

This is a clinical practice guideline for adults who have undergone polypectomy or colorectal cancer resection. The guideline provides a framework on the use of colonoscopy and non-colonoscopic colorectal imaging for the surveillance of these patients. Specific topics addressed include the selection of patients for surveillance, appropriate surveillance intervals, and the timing of surveillance cessation.

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.

This is a clinical practice guideline for patients who are at risk for developing, or who have been diagnosed with, colon cancer. The guideline examines the screening, diagnosis, treatment and follow-up of this patient population. Treatment options are presented based on the stage of cancer, and include surgical options, surveillance, and much more. 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.

This is a clinical practice guideline for patients who are at an increased risk of developing colorectal cancer (CRC), due to hereditary factors. The guideline examines the management of these patients, including the prevention of CRC, diagnosis of CRC, endoscopic management, and surgical care. Specific hereditary conditions discussed include Lynch syndrome, Lynch-like syndrome, serrated polyposis syndrome, familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Outcomes of interest include decreasing the lifetime risk of developing CRC, decreasing morbidity due to CRC or its treatment, as well as improving the identification of hereditary CRC syndromes.

This is a clinical practice guideline for adult patients who have completed treatment for stage I, II, or III colorectal cancer (CRC). The guideline provides recommendations on the post-treatment surveillance of these patients, including the appropriate use and timelines for colonoscopy, computed tomography (CT) scans of the chest, abdomen and pelvis, as well as carcinoembryonic antigen (CEA) protein tests. The guideline also discusses which providers should lead post-treatment surveillance programs.

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.

This is a clinical practice guideline for patients who are at average or high risk of developing colorectal neoplasia. The guideline discusses the role of different imaging techniques for polyp detection and/or characterization. The role of artificial intelligence in the detection and characterization of colorectal lesions, including possible hazards of its implementation, is also addressed.

This is a clinical practice guideline for surveillance colonoscopy in adult populations identified with precancerous lesions detected by colonoscopy, those with a diagnosis of colorectal cancer (CRC), and/or people with a diagnosis of inflammatory bowel disease (ulcerative colitis or Crohn's disease). The guideline discusses the appropriate timing of colonoscopies in these patients. Other topics discussed include advances in colonoscopy, and the management of anxiety in patients who are undergoing the procedure. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of August 30th, 2019.

This is a clinical practice guideline for patients with potential or confirmed early-stage colorectal neoplasia. The guideline provides recommendations on lower GI endoscopy in these patients for the purposes of screening, diagnosis, and early characterization. Adequate bowel preparation, the use of antispasmodic agents for lesion detection, and image-enhanced endoscopy (IEE) are examples of specific topics discussed.

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.

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.

This is a clinical practice guideline for patients with completely resected stage 3 colon cancer. The guideline examines the optimal duration of oxaliplatin-containing chemotherapy for these patients. Specifically, comparisons in disease-free survival and adverse events are discussed for 3-month treatment versus 6-month treatment durations.

This is a clinical practice guideline for patients with advanced colorectal cancer. The guideline aims to improve the quality of life for these patients by integrating an early palliative care approach into advanced cancer care. Topics of interest include illness comprehension and coping, symptoms and functional status, advance care planning as well as patient's preferred method of decision making, and coordination of care.

This is a clinical practice guideline on screening for colorectal cancer. The guideline compares fecal immunochemical testing (FIT) every year, FIT every two years, one-time sigmoidoscopy, and one-time colonoscopy as screening options. Outcomes of interest include colorectal cancer incidence, and mortality.

This is a clinical practice guideline for the work-up of suspicious colorectal masses following screening, as well as for the treatment of patients with diagnosed colorectal cancer. Treatment options discussed include surgery, adjuvant chemotherapy, and adjuvant radiotherapy. Recommendations are separated based on location and stage of disease, with the guideline specifically addressing localized rectal cancer, localized colon cancer, locally advanced unresectable colorectal cancer, up-front resectable metastatic colorectal cancer, and more.

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.

This is a clinical practice guideline for patients with post-colonoscopy colorectal cancer (PCCRC) or post-imaging colorectal cancer (PICRC). The guideline examines the identification, analysis, and reporting of these cancers. Methods for assessing an individual PCCRC case, methodology for assessing PCCRC rates across services, and non-colonoscopic imaging of the colon are discussed. The prevention of PCCRC and PICRC in high-risk groups is also addressed.

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.

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.

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.

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.

This is a clinical practice guideline for patients with non-pedunculated colorectal lesions. The guideline examines the use of endoscopic mucosal resection (EMR) for the treatment of these patients. Indications for EMR, patient requirements and preparation, patient information, identification and characterization of the lesion, technical aspects, intra-and post-operative complications, and efficacy and monitoring are discussed. The competence of the individual performing the EMR is also considered.

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.

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.

This is a clinical practice guideline for adults with cystic fibrosis (CF). The guideline discusses screening for colorectal cancer (CRC), specific to this population, given that life expectancy and risk of developing CRC differ from the general population. Recommendations on screening practices are provided based on the age and health condition of patients, with the primary outcomes of interest being increased early detection of CRC, and decreased morbidity and mortality due to CRC in patients with CF.

This is a clinical practice guideline for patients with colorectal cancer (CRC). The guideline provides recommendations for the management of emergencies including perforation and obstruction of the left or right colon. Ileostomy, colectomy, proctosigmoidectomy, and non-surgical procedures such as the use of self-expandable metallic stents (SEMSs), are discussed as potential management options.

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.

This is a clinical practice guideline for asymptomatic adults who are at average risk of developing colorectal cancer (CRC). The guideline examines screening for CRC, and provides recommendations that are stratified by age.

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).

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.

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.

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.

This is a clinical practice guideline for adult cancer patients. The guideline provides recommendations for the diagnosis and treatment of non-infectious and infectious gastrointestinal complications often experienced by these patients. Specific conditions examined include paraneoplastic diarrhea, therapy-associated diarrhea, neutropenic enterocolitis, Clostridium difficile infection, other bacterial infections causing diarrhea (e.g. non-typhoidal Salmonella, Shigella, Yersinia, and Campylobacter spp.), viral infections, and parasitic infections.

This is a clinical practice guideline on enhanced recovery after colon and rectal cancer surgery. Recommendations address the appropriate preoperative, perioperative and postoperative interventions that contribute to improved patient recovery. Outcomes of interest include freedom from nausea, freedom from pain at rest, early return of bowel function, improved wound healing, and early hospital discharge.

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.

This is a clinical practice guideline for the management of rectal cancer in adult patients. The guideline discusses the indications for neoadjuvant therapy, the quality criteria for surgical resection, the management of postoperative disordered function, the role of local excision in early rectal cancer, the role of conservative strategies after neoadjuvant treatment, the management of synchronous liver metastases, as well as the indications for adjuvant therapy.

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.

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.

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.

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.

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.

This is a clinical practice guideline for adults with colorectal cancer (CRC). The guideline discusses the treatment of these patients, and provides specific recommendations on endoscopic treatment, treatment of stage 0 to stage 4 CRC, treatment of metastases of the liver and lung, treatment of recurrent CRC, and surveillance after surgery. Adjuvant chemotherapy and radiotherapy are also examined, as are approaches to palliative care.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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?

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.