Cancer Guidelines Database

This is a clinical practice guideline for the surveillance of patients who have undergone polypectomy. The quality of baseline colonoscopy, polyp size evaluation, appropriate scheduling of colonoscopy surveillance, patient selection for surveillance, timing of second surveillance colonoscopy, piecemeal resection, and ending post-polypectomy surveillance are specifically discussed. The primary outcomes of interest are colorectal cancer incidence and mortality.

This is a clinical practice guideline on self-expandable metal stents for patients with colonic or extracolonic cancer. The guideline specifically applies to patients with left-sided colon cancer arising from the rectosigmoid colon, sigmoid colon, descending colon, or splenic flexure and not those with rectal cancers or cancers proximal to the splenic flexure. Various aspects of colonic stenting are discussed, including technical considerations, colonic stenting as a bridge to elective surgery, palliative colonic stenting, and adverse events.

This is a clinical practice guideline for adults with chronic gastroesophageal reflux disease (GERD). The guideline provides recommendations on the diagnosis of esophageal cancer and precancerous conditions in these patients. Specifically, the guideline discusses endoscopic screening to detect cancer at an earlier stage, to detect precancerous treatable conditions (e.g., Barrett esophagus, dysplasia), to reduce progression to esophageal adenocarcinoma, and to decrease mortality.

This is a clinical practice guideline for adults with suspected or confirmed pancreatic adenocarcinoma. The guideline provides recommendations for the diagnosis and staging of these patients, as well as treatment options based on disease stage. Specific recommendations are provided based on whether the patient has potentially curable pancreatic adenocarcinoma, or unresectable pancreatic adenocarcinoma, with the latter including chemotherapy, the removal of biliary obstructions, and palliative approaches.

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 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 patients with gastric cancer. The guideline examines the pathology, initial workup, staging, treatment, follow-up, and supportive care of these patients. Treatment options discussed include lymph node dissection, laparoscopic resection, endoscopy, radiation therapy, combined modality therapy, chemotherapy (preoperative, perioperative, and postoperative), and targeted therapies.

This is a clinical practice guideline for adults with esophageal or esophagogastric junction cancer. The guideline specifically examines the initial workup, histological staging, primary treatment, and follow-up of both squamous cell carcinoma and adenocarcinoma. Treatment modalities discussed include surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies.

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 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 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 pancreatic cancer. The guideline examines the diagnosis, work-up and treatment of these patients at all stages. Specific topics discussed include the staging system for adenocarcinoma of the pancreas, management options, and referrals to palliative care.

This is a clinical practice guideline for patients with malignant colorectal polyps. The guideline examines how to assess lesions for endoscopic features associated with cancer, discusses how these factors guide endoscopic management, and outlines the factors that frame whether to advise surgery after a malignant polyp has been endoscopically resected. Endoscopic and histologic classification systems, endoscopic surface pattern classifications, and histologic classification systems for depth of cancer invasion, are specifically discussed.

This is a clinical practice guideline for adults with esophageal cancer, including both squamous cell esophageal cancer and adenocarcinoma. The guideline provides recommendations for the diagnosis and staging of these patients, as well as treatment options based on disease stage. The treatment of potentially curable esophageal cancer, as well as palliative approaches to incurable esophageal cancer, are specifically discussed.

This is a clinical practice guideline for adults with squamous cell carcinoma arising within the anal canal. The guideline provides recommendations for the diagnosis and staging of these patients, as well as specific treatment recommendations based on disease stage. Specific topics addressed include the treatment of patients who have undergone curative therapy, those with locally recurrent cancer, and those with metastatic cancer.

This is a clinical practice guideline for adults with hepatocellular carcinoma (HCC), with specific recommendations for patients with very early stage, early stage, intermediate stage, advanced stage, and terminal stage HCC. The guideline examines the diagnostic work-up, management, and follow-up of these patients. For each HCC stage, the patient requirements, tumour requirements, goals of treatment, and specific management options are discussed.

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 is a clinical practice guideline for hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.

This is a clinical practice guideline on the use of liver biopsy for the diagnosis or management of liver disease in patients for whom clinical information cannot be obtained by non-invasive techniques. The guideline examines indications for liver biopsy, biopsy techniques, procedural considerations, and guidelines for follow-up care. Specific biopsy techniques discussed include percutaneous biopsy, transvenous biopsy, transjugular biopsy, transfemoral biopsy, endoscopic ultrasound (EUS) guided biopsy, and laparoscopic biopsy.

This is a clinical practice guideline for patients with colorectal cancer. The guideline examines clinical indications for the use of imaging alternatives to standard colonoscopy in these patients, including computed tomographic colonography (CTC) and colon capsule endoscopy (CCE). Radiological imaging for the diagnosis of colorectal neoplasia, completion of a previously incomplete colonoscopy, indications and contraindications to CTC/CCE following positive fecal occult blood test or fecal immunochemical test, and post-polypectomy surveillance are specifically discussed, as are indications and contraindications for CTC, the latter of which including diverticular disease, inflammatory bowel disease, and patient fragility.

This is a clinical practice guideline for patients with metastatic pancreatic adenocarcinoma. The guideline examines therapy options after first-line treatment in these patients. Specific topics of interest include initial patient assessment, palliative care, treatment of pain and/or symptoms, as well as follow-up and surveillance strategies.

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 patients with gastric intestinal metaplasia (GIM) detected as part of routine upper endoscopy. The guideline examines the management of these patients, including the testing and treating of Helicobacter pylori infections, as well as subsequent surveillance using upper endoscopy. Outcomes of interest include early gastric cancer detection, reduced morbidity and mortality from gastric cancer, complications associated with endoscopy, and psychological outcomes.

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 for patients with small bowel adenocarcinoma. The guideline discusses the clinical presentation and workup, pathology, staging, and treatment of these patients. Treatment options are specifically addressed for stage I-III and distant metastatic (stage IV) small bowel adenocarcinomas. Risk factors, post-treatment surveillance and survivorship are also examined.

This is a clinical practice guideline for adult patients with confirmed or suspected gastric cancer. The guideline examines the diagnostic workup and treatment options for this patient population. Specific treatment options are outlined based on disease stage and tumour genomics (e.g., HER2 expression).

This is a clinical practice guideline for patients with suspected or confirmed esophageal cancer. The guideline examines the diagnosis, staging, and treatment of these patients, and includes a discussion of multiple treatment modalities. Outcomes of interest include morbidity, local recurrence, and survival.

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 with small bowel adenocarcinoma. The guideline discusses the clinical presentation and workup, pathology, staging, and treatment of these patients. Treatment options are specifically addressed for stage I-III and distant metastatic (stage IV) small bowel adenocarcinomas. Risk factors, post-treatment surveillance and survivorship are also examined.

This is a clinical practice guideline for patients with gastric cancer. The guideline examines the pathology, initial workup, staging, treatment, follow-up, and supportive care of these patients. Treatment options discussed include lymph node dissection, laparoscopic resection, endoscopy, radiation therapy, combined modality therapy, chemotherapy (preoperative, perioperative, and postoperative), and targeted therapies.

This clinical practice guideline is for the management of squamous cell anal carcinoma. The guideline provides recommendations on staging, treatment, and follow-up. The effectiveness of treatment options such as surgery, chemotherapy, and radiation therapy are compared. Guidance is also provided on dosing regimens, treatment of recurrence, and surveillance following treatment of recurrence.

This is a clinical practice guideline for patients with pancreatic cancer. The guideline examines radiation therapy (RT) and stereotactic body radiation therapy (SBRT) in these patients, and provides guidance for treatment planning and the management of RT-associated toxicities. Specific topics discussed include the indications for conventionally fractionated RT and SBRT, appropriate dose-fractionation and target volumes, sequencing of chemotherapy and RT, indications for palliative RT, and prophylactic medications for mitigating toxicity.

This is a clinical practice guideline for bowel preparation prior to colonoscopy procedures. The guideline examines appropriate preparation methodologies for adult patients, including special populations such as patients who are pregnant/lactating, patients with inflammatory bowel disease (IBD) and elderly people. Outcomes of interest include adverse events, postoperative complications and postoperative morbidity.

This is a clinical practice guideline for adult patients who are at an increased risk of developing gastric adenocarcinoma, specifically those with gastric atrophy (GA), gastric intestinal metaplasia (GIM), gastric epithelial dysplasia or early gastric adenocarcinoma limited to the mucosal or superficial submucosal layers. The guideline provides recommendations for the diagnosis and management of these patients, while addressing specific topics such as Helicobacter pylori eradication, endoscopic screening, and endoscopic mucosal resection.

This is a clinical practice guideline for adults with appendiceal neoplasms, excluding GI stromal tumours, lymphomas, and neural proliferations. The guideline provides recommendations on the management of these patients. Specific topics discussed include colonoscopy, pre-operative assessment, appendectomy, biochemical testing, and post-operative surveillance. Outcomes of interest include recurrence rate of neoplasms and disease-free survival.

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 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 adults with rectal cancer. The guideline discusses the treatment of rectal cancer using local excision (LE), with or without neoadjuvant radiation therapy or chemoradiation. Outcomes of interest include anorectal function, tumour recurrence and overall quality of life.

This is a clinical practice guideline for adult patients with hepatocellular carcinoma (HCC). Specifically, the guideline provides recommendations for the non-surgical management of patients with locally advanced or advanced HCC, Barcelona Clinic Liver Cancer (BCLC) Stage B and higher, who are not suitable for transplant or surgery. The guideline compares transarterial chemoembolization (TACE) to other local therapies, including transarterial ethanol ablation (TEA), bland transarterial embolization (TAE), radiofrequency ablation (RFA), transarterial radioembolization (TARE), stereotactic body radiation therapy (SBRT) and drug eluting bead transarterial chemoembolization (DEB-TACE). The addition of systemic treatment regimens, such as sorafenib, is also discussed.

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 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 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 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 adults with primary sclerosing cholangitis (PSC) or those presenting with similar cholangiopathies which may mimic PSC, such as IgG4-related sclerosing cholangitis. The guideline examines the diagnosis and management of these patients, including the role of liver biopsy, non-invasive assessment of liver fibrosis, overlap syndromes, the role of endoscopy, ERCP and endotherapy, specialist referral, liver transplantation, and the management of complications. Screening for cancer in PSC, pregnancy in women with PSC, patient perspectives and support groups, and service standards, are also discussed.

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 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 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 management of epithelial precancerous conditions and lesions in the stomach. The guideline specifically addresses the diagnostic assessment, treatment and surveillance of individuals with atrophic gastritis, intestinal metaplasia, and dysplasia of the stomach. Topics discussed include endoscopic diagnosis, biopsies and histology, noninvasive assessment, management, Helicobacter pylori treatment, follow-up, and the cost-effectiveness of surveillance and screening.

This is a clinical practice guideline for patients with resected biliary tract cancer, including cancers of the intrahepatic bile ducts, perihilar and distal extrahepatic bile ducts, and the gallbladder. The guideline provides recommendations on adjuvant therapy, including fluoropyrimidine-based or gemcitabine-based chemotherapy and/or radiation therapy. Outcomes of interest include relapse-free survival (RFS) and overall survival (OS), as well as quality of life (QOL).

This is a clinical practice guideline for adult patients who are at risk for or who have been diagnosed with Barrett's esophagus (BE). The guideline examines the screening and surveillance of BE in these patients, while specifically discussing the role of chromoendoscopy, confocal laser endomicroscopy, volumetric laser endomicroscopy, and wise-area transepithelial sampling for the purpose of increasing the rate of dysplasia detection. The primary outcome of interest is the early detection of esophageal adenocarcinoma (EAC).

This is a clinical practice guideline for patients with hepatitis C virus (HCV) infection who have received direct-acting antiviral (DAA) medication. The guideline provides recommendations on the follow-up these patients for the purposes of reducing the incidences of hepatocellular carcinoma (HCC), as well as hepatitis B virus (HBV) reactivation in those who are co-infected with HBV and HCV. Surveillance intervals and monitoring techniques are specifically discussed, with recommendations separated based on whether patients have a history of HCC.

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 clinical practice guideline provides recommendations for the management of gastric cancer across most components of the cancer care continuum. Topics of discussion include risk factors for stomach cancer, indicated diagnostic tests, staging criteria, recommended treatment options for each stage (including palliative radiation therapy and chemotherapy), and recommended surveillance methods for follow-up. 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 risk for developing, or who have been diagnosed with, rectal 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 hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.

This is a clinical practice guideline for adults with hepatocellular carcinoma (HCC). The guideline provides recommendations for the diagnosis and management of these patients. Recommendations are separated based on whether a patient has very early stage HCC, early stage HCC, intermediate stage HCC, advanced stage HCC, or terminal stage HCC. Biopsy in patients without cirrhosis is also addressed.

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 adult patients with cholangiocarcinoma or gallbladder cancer. The guideline discusses the diagnosis, staging, and treatment of these patients, with the overall goals of rendering patients free of disease, delaying or preventing recurrence, and/or improving survival. Different recommendations are provided for patients with proximal cholangiocarcinoma and gallbladder carcinoma, as well as distal cholangiocarcinoma.

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 adult patients who are undergoing liver transplantation, and is specifically targeted towards Asian patients. The guideline provides recommendations for the immunosuppression of these patients, and includes a discussion of several immunosuppressants. Specific topics addressed include the effects of various agents on renal toxicity, hepatocellular carcinoma recurrence, and the impact of non-adherence to immunosuppressive therapy.

This is a clinical practice guideline for the diagnosis and treatment of anal intraepithelial neoplasia (AIN). Diagnostic elements discussed include clinical evaluation with associated digital rectal examination (DARE), as well as brushing and viral typing, anoscopy, and biopsy. For the treatment of AIN, the guideline examines topical treatments such as imiquimod, 5-fluorouracil (5-FU), cidofovir and trichloroacetic acid (TCA), as well as ablative methods, including electrocautery, radiofrequency ablation (RFA), CO2 laser therapy, infrared coagulation (IRC), photodynamic therapy and surgery. The primary outcome of interest is the prevention of squamous cell carcinoma (SCC).

This is a clinical practice guideline for patients who have been diagnosed with or who are at high risk for hepatocellular carcinoma (HCC). The guideline provides recommendation for the primary, secondary, or tertiary prevention of HCC, the surveillance of patients who are at high risk for developing HCC, the diagnosis and staging of HCC, as well as the treatment and follow-up of patients with HCC. Surgery and radiation therapy are the primary treatment modalities discussed.

This is a clinical practice guideline for asymptomatic adults. The guideline discusses the appropriateness of pancreatic cancer screening in this general population. Outcomes of interest include diagnostic accuracy, harms of screening, morbidity, and mortality.

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 adults with esophageal or esophagogastric junction cancer. The guideline examines the initial workup, histological staging, primary treatment, and follow-up of both squamous cell carcinoma and adenocarcinoma. Treatment modalities discussed include surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies.

This is a clinical practice guideline for patients diagnosed with pancreatic adenocarcinoma. The main focus of the guideline is on adjuvant therapy for these patients who have undergone an R0 or R1 resection of their primary tumour, however the guideline also examines the general management of pancreatic cancer patients including initial assessment before therapy, which patients should be offered a potentially curative strategy with resection, when palliative care services should be initiated, and the frequency of follow-up care/surveillance.

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 for patients with pancreatic ductal adenocarcinoma (PDAC). The guideline examines the screening, diagnosis, treatment and follow-up of these patients, with recommendations separated based on extent of disease (i.e. operable PDAC, locally advanced PDAC, or metastatic PDAC). Diagnostic methods examined include imaging and the use of serum tumour markers such as carbohydrate 19-9 antigen (CA19-9), and various treatment options are also discussed, including surgery and chemotherapy.

This is a clinical practice guideline for patients with primary liver cancer (PLC). The guideline examines the integrative use of traditional Chinese medicine (TCM) and Western medicine for PLC. Early treatment by TCM after surgery, TCM combined with transcatheter arterial chemoembolization for advanced PLC, TCM drugs for external use, and acupuncture and moxibustion therapy are among the topics discussed.

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 that aims to support clinicians in the evaluation of gastroenteropancreatic neuroendocrine tumour (GEP-NET) progression and treatment response. Topics of discussion include morphological imaging, molecular imaging, and pseudoprogression. Recommendations are provided pertaining to the imaging tools and optimal techniques that should used for monitoring patients and evaluating treatment response. Recommendations are also provided for the surveillance of patients with metastatic GEP-NETs, including the appropriate frequency of follow-up.

This is a clinical practice guideline for hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.

This provisional clinical opinion addresses identification and management of patients and family members with possible predisposition to pancreatic adenocarcinoma. Recommendations are provided around the appropriate methods for determining patients' susceptibility to developing pancreatic cancer, which individuals should undergo genetic testing, and the surveillance strategies that should be used for individuals with predispositions to pancreatic ductal adenocarcinoma to screen for pancreatic and other cancers.

This is a clinical practice guideline for patients with Barrett's esophagus (BE), which is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC). The guideline examines endoscopic eradication therapy (EET) and its role in the management of BE-related neoplasia. Outcomes of interest include progression to cancer, cancer-specific and all-cause mortality, adverse events, and recurrence rates.

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 pancreatic adenocarcinoma. The guideline examines risk factors and genetic predisposition, pancreatic cancer screening, diagnosis and staging, systemic therapy approaches, radiation and chemoradiation approaches, surveillance of patients with resected disease, as well as palliative and supportive care. Management of metastatic disease, locally advanced disease, resectable and borderline resectable disease, and recurrent disease after resection is also considered.

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 patients with squamous cell cancers (SCC) of the anal canal and perianal region. The guideline specifically examines management options for premalignant and malignant squamous neoplasms of the anus and perianal region. Recommendations are provided regarding screening options, primary treatment, and surveillance for SCC and perianal squamous cell cancers.

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 clinical practice guideline is for the management of squamous cell anal carcinoma. The guideline provides recommendations on staging, treatment, and follow-up. The effectiveness of treatment options such as surgery, chemotherapy, and radiation therapy are compared. Guidance is also provided on dosing regimens, treatment of recurrence, and surveillance following treatment of recurrence.

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 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 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 adults with newly-diagnosed or recurrent oesophago-gastric cancer. The guideline discusses clinical assessment, radical and palliative treatment, follow-up, nutritional support, and service organization. The primary outcomes of interest are increases in quality of life and survival.

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 hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.

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 adult patients with esophageal cancer or cancer of the gastro-esophageal junction. The guideline provides recommendations on assessment, systemic therapy, surgical approaches, and post-curative therapy follow-up of these patients. The discussion of treatment is stratified by stage, performance status, and disease type. Chemotherapy regimens are also considered.

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 metastatic pancreatic cancer. The guideline examines the appropriate therapy for patients with metastatic pancreatic cancer who experience either disease progression or intolerable toxicity with prior regimens. Options for routine testing of patients who are considered to be candidates for checkpoint inhibitor therapy are discussed, as are programmed cell death-1 (PD-1) immune checkpoint inhibitor pembrolizumab as second-line therapy, and the use of fluorouracil with either nanoliposomal irinotecan, irinotecan, or oxaliplatin.

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 suspected or confirmed esophageal cancer, and specifically for those with epithelial cancer originating in the esophagus. The guideline provides recommendations for the diagnosis, staging, treatment and follow-up of these patients, with treatment guidelines based on disease type and stage. Specific topics discussed include the diagnostic differentiation between T1a‑EP/LPM and T1a‑MM disease, the selection of lesions for endoscopic treatment, the prevention of post-endoscopy stenosis, as well the relative appropriateness of surgery or definitive chemoradiotherapy.

This is a clinical practice guideline for patients with suspected upper gastrointestinal (GI) cancer. The guideline provides recommendations for the preparation and application of image-enhanced endoscopy (IEE) used in the diagnosis of these patients. Outcomes of interest include enhanced quality of endoscopic diagnosis and improved detection of early upper GI cancers.

This is a clinical practice guideline for the diagnosis and treatment of patients with pancreatic cystic neoplasms (PCN). The use of blood and cystic biomarkers, as well as imaging modalities such as magnetic resonance imaging / cholangiopancreatography (MRI/MRCP), computed tomography (CT), and endoscopy guided ultrasound (EUS) are all discussed as potential diagnostic approaches. Management options are presented based on tumour-specific features such as size, as well as general clinical features like the presence of jaundice.

This is a clinical practice guideline for patients with pancreatic adenocarcinoma. The guideline examines risk factors and genetic predisposition, pancreatic cancer screening, diagnosis and staging, systemic therapy approaches, radiation and chemoradiation approaches, surveillance of patients with resected disease, as well as palliative and supportive care. Management of metastatic disease, locally advanced disease, resectable and borderline resectable disease, and recurrent disease after resection is also considered.

This is a clinical practice guideline for hepatocellular carcinoma (HCC) occurring in adult patients with cirrhosis. The guideline examines techniques for surveillance and screening, diagnostic evaluation methods, and the various therapeutic options for the treatment of HCC. Outcomes of interest include the sensitivity and specific of screening tests, as well as morbidity, recurrence, and survival.

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 adults with suspected pancreatic cancer, or those with newly diagnosed or recurrent pancreatic ductal adenocarcinoma. The guideline provides recommendations for the monitoring of people with an inherited high risk of pancreatic cancer. Recommendations are also made for diagnosis, staging, psychological support, pain and nutrition management, as well as management for resectable, borderline resectable, and unresectable cancer.

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 gastric cancer. The guideline examines the pathology, initial workup, staging, treatment, follow-up, and supportive care of these patients. Treatment options discussed include lymph node dissection, laparoscopic resection, endoscopy, radiation therapy, combined modality therapy, chemotherapy (preoperative, perioperative, and postoperative), and targeted therapies.

This is a clinical practice guideline for adults with esophageal or esophagogastric junction cancer. The guideline examines the initial workup, histological staging, primary treatment, and follow-up of both squamous cell carcinoma and adenocarcinoma. Treatment modalities discussed include surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies.

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 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 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 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 adults with hepatocellular carcinoma (HCC). The guideline examines the goals of therapy, and provides recommendations for the treatment of patients with different stages of HCC, from very early stages to terminal stage. Outcomes of interest include rendering the patient free of disease, preventing recurrence, and improving quality of life.

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 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 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 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 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 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 management of adult patients with adenocarcinoma of the pancreas. The guideline provides recommendations on diagnostic work-up, staging, and treatment options based on stage of cancer. Specific topics discussed include management recommendations for unresectable adenocarcinoma, and toxicity-associated dose modification. Outcomes of interest include adverse events, overall survival, and quality of life.

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 Stage I to IV gastric cancer (specifically gastric adenocarcinoma) who are being considered for surgery. The guideline examines the optimal techniques to adequately stage gastric cancer, and the optimal techniques of gastric cancer surgery with curative intent. The guideline also considers indications for surgery for Stage IV gastric cancer in asymptomatic and symptomatic patients, and the relationship between surgical volumes and outcomes.

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 clinical practice guideline is part three of a series focusing on the management of pancreatic cancer (PC). The guideline focuses on the neoadjuvant and induction therapies for PC and locally advanced pancreatic cancer (LAPC). Comparisons are made between the clinical effectiveness of neoadjuvant treatment with chemotherapy, radiotherapy or both.

This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 guideline titled Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline. The update focuses solely on new evidence that pertains to clinical question 4 of the guideline: What is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection of their primary tumour? Outcomes of interest include treatment efficacy, and improved survival.

This is a clinical practice guideline for the assessment of liver metastases. The guideline provides recommendations regarding the appropriateness of imaging modalities and the optimization of imaging parameters for specific clinical scenarios, including diagnosis, staging, and surveillance. Outcomes of interest include accuracy in characterizing and detecting liver lesions, length of examination, and potential adverse health effects, as well as surveillance sensitivity, specificity, and reproducibility.

This is a clinical practice guideline for adults and children with pancreatic ductal adenocarcinoma. Different variations of imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) are discussed. The guideline examines the appropriateness of these techniques for two clinical situations: during initial staging before treatment, and following neoadjuvant therapy to evaluate tumour resectability for borderline resectable tumours.

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 hepatitis C virus (HCV) infection who are candidates for liver transplantation (LT). Specifically, the guideline provides recommendations on the treatment of patients with compensated cirrhosis and hepatocellular carcinoma (HCC), the treatment of patients with decompensated cirrhosis with or without HCC, the management of HCV in the context of an anti-HCV-positive donor, the treatment of post-transplant severe cholestatic hepatitis, the treatment of recurrent HCV infection, the treatment of recurrent HCV cirrhosis, and the treatment of HCV pre- and post-LT in human immunodeficiency virus (HIV)-HCV co-infected patients. Outcomes of interest differ between specific patient populations, and include wait-list mortality, post-LT survival, HCV recurrence post-LT, and the development of extrahepatic complications.

This is a clinical practice guideline for patients with incidentally detected gallbladder polyps. The guideline examines the management and follow-up of these patients. Specific topics addressed include which patients require cholecystectomy, which patients require ultrasound follow-up, and what the frequency and duration of follow-up should be.

This is a clinical practice guideline on the use of endoscopy for the diagnosis of upper gastrointestinal (UGI) cancers. Pre-procedural, procedural, post-procedural, and disease-specific recommendations are provided. The primary outcome of interest is to optimize the diagnosis of early neoplasia and premalignant conditions of the upper gastrointestinal tract, in order to reduce the effects of UGI cancers which are often associated with a poor prognosis due to late detection.

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 is part two of a series focusing on the management of pancreatic cancer (PC). The guideline focuses on the diagnosis of pancreatic cancer, and provides recommendations regarding imaging tests such as endoscopic ultrasound (EUS), positron emission tomography (PET), and laparoscopy. The use of serum biomarkers during diagnostic work-up, and tests to assess curative resectability of pancreatic tumours, are also 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 patients with gastroesophageal adenocarcinoma. The guideline provides recommendations for the assessment of HER2 (or erb-b2 receptor tyrosine kinase (ERBB2)) mutations, while addressing which patients and tumour specimens are appropriate. Outcomes of interest include increased accuracy of HER2 testing, and increased utility for clinician decision-making.

This is a clinical practice guideline to guide appropriate prescribing of filgrastim in adults. The guidelines looks at a variety of disease sites and is intended as a guide to facilitate a shared approach to the appropriate use of filgrastim. In order provide clarity surrounding the indications in which filgrastim should be used, the recommendations are presented by disease site.

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.

A clinical practice guideline for patients with gastrointestinal stromal tumours. The guideline examines appropriate imaging modalities, and treatment for newly diagnosed and metastatic tumours. Outcomes of interest include disease progression and recommended imaging.

This clinical practice guideline provides recommendations on the diagnosis and treatment of locally advanced and borderline resectable pancreatic cancer. Radiotherapy alone is compared to chemoradiation for treatment of locally advanced disease, and preoperative therapy for borderline resectable disease is discussed. The guideline reviews neoadjuvant systemic therapy followed by local treatment and provides recommendations on chemotherapy regimes. Outcomes of interest include progression-free survival, median survival, 1-year survival, and local control.

This clinical practice guideline provides recommendations on the investigation, treatment, and follow-up care of patients aged 16 years and older with cancer of the upper aerodigestive tract. HPV-related disease and less common upper aerodigestive tract cancers including carcinoma of the nasopharynx or paranasal sinuses, unknown primary of presumed upper aerodigestive tract origin, and mucosal melanoma, are also reviewed. Additionally, recommendations are provided on optimizing rehabilitation and function. Outcomes of interest include prevalence, predictive value, sensitivity, specificity, local control, survival (overall, progression-free), treatment-related morbidity and mortality, and resource use, among others.

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 the diagnosis, treatment and follow-up of patients with gastrointestinal stromal tumours (GISTs). The guideline discusses the diagnosis of GISTs using radiology, histology and molecular biology, while also providing recommendations for the treatment of both localized and advanced disease. Surgery, adjuvant and neoadjuvant treatment options are specifically examined.

This is a clinical practice guideline for adults diagnosed with incurable gastroenteropancreatic neuroendocrine tumours. The guideline examines treatment options for pancreatic neuroendocrine tumours and non-pancreatic neuroendocrine tumours, including chemotherapy, targeted therapy, somatostatin analogues and interferon, and combination therapy. Outcomes of interest include progression-free and overall survival, adverse events, and quality of life.

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 patients with neoplasms causing biliary obstruction. The guideline examines the management of malignant biliary obstructions, including diagnostic work-up and treatment options. Recommendations are provided based on factors such as the resectability and location of the obstruction. Outcomes of interest include improved quality of life (QOL) and prolonged survival.

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 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 resectable pancreatic cancer. The guideline reviews biomarkers, specifically carbohydrate antigen 19-9 (CA19-9), and SMAD4 (DPC4), as well as other prognostic factors such as resection margin status and lymph node involvement. Adjuvant therapy, neoadjuvant therapy, and radiotherapy are discussed as treatment options, taking patient risk factors for local recurrence into consideration.

This clinical practice guideline discusses the evaluation and treatment of patients with suspected solid pancreatic neoplasia. The guideline reviews presentation and clinical evaluation of pancreatic neoplasia, and provides an overview of radiologic and endoscopic modalities for adenocarcinoma of the pancreas, neuroendocrine tumours (NETS) of the pancreas, solid pseudopapillary tumours (SPTs), metastatic disease, and lymphoma. Screening for pancreatic cancer is also discussed. Outcomes of interest include sensitivity and specificity, as well as adverse events.

This is a clinical practice guideline for gastric cancer. The guideline provides an evidence- and consensus-based treatment approach for the management of patients with gastric cancer. Topic areas discussed within the guideline include: staging, principles of pathology, surgery, endoscopic therapies, radiation therapy, combined modality therapy, chemotherapy, and follow-up.

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 the screening, diagnosis, staging, and treatment of neuroendocrine tumors. This guideline provides recommendations on issues including: multiple endocrine neoplasia, surveillance of resected neuroendocrine tumors of the gastrointestinal tract, lung, and thymus, and genetic counseling/testing in pheochromocytomas/paragangliomas. Most of the guideline sections pertain to well-differentiated, low- to intermediate-grade tumors, although poorly differentiated/high-grade/large or small cell carcinomas are also addressed.

This is a clinical practice guideline for the treatment of patients with metastatic pancreatic cancer. This clinical practice guideline addresses six overarching clinical questions: After a histopathologic confirmation of pancreatic adenocarcinoma diagnosis, what initial assessment is recommended before initiating any therapy for metastatic pancreatic cancer? What is the appropriate first-line treatment of patients with metastatic pancreatic cancer? What is the appropriate therapy for patients with metastatic pancreatic cancer who experience either disease progression or intolerable toxicity with prior regimens for metastatic pancreatic cancer? When should the concept of palliative care be introduced? For patients with metastatic pancreatic cancer, what are the recommended strategies for relief of pain and symptoms? What is the recommended frequency of follow-up care/surveillance for patients with metastatic pancreatic cancer?

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 patients with rectal cancer. The guideline provides recommendations on use of MRI for staging, optimal surgical techniques for patients with T1-T2 anal cancer with comparisons made between local resection or transanal endoscopic microsurgical resection and radical resection, and the use of adjuvant chemotherapy for patients who have received neoadjuvant radiotherapy (RT). Outcomes of interest include survival (overall, disease free, metastasis-free, local recurrence free), and quality of life.

This is a clinical practice guideline for adult patients with pancreatic neoplasms. The guideline provides recommendations for the use of laparoscopic pancreatic surgery (LAPS) in these patients, with a specific focus on laparoscopic distal pancreatectomy, laparoscopic pancreatoduodenectomy, laparoscopic pancreatic enucleation, and laparoscopic central pancreatectomy. Other topics discussed include laparoscopic compared to robotic pancreatic surgery, and the use of intraoperative laparoscopic ultrasound as compared to pre-operative imaging.

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 guideline aims to described the role of esophageal stents in patients with malignant or benign esophageal disease and makes recommendations on circumstances that warrant their use. Questions addressed in this guideline include: what are the results for palliative stent placement compared to other treatment modalities; what are the short-term and long-term adverse events of stent placement; and can stents be used to treat benign esophageal leaks and perforations.

This is a clinical practice guideline for patients with anal carcinoma. Risk factors are discussed and recommendations are provided on risk reduction including HIV immunization, work up, management, and follow-up care. Treatment options are reviewed, with specific recommendations provided for primary treatment of: non-metastatic anal carcinoma, anal canal cancer, and anal margin cancer, as well as treatment for metastatic cancer and for locally progressive or recurrent anal carcinoma. Special considerations are made regarding treatment of anal cancer in patients with HIV/AIDS.

This clinical practice guideline provides evidence-based recommendations to oncologists and others for treatment of patients with locally advanced, unresectable pancreatic cancer (LAPC). The guideline addresses a number of key clinical questions including: what initial assessment is recommended before initiating therapy for LAPC; what is the appropriate initial treatment approach for people diagnosed with LAPC; and for people with LAPC, what are the recommended strategies for relief of pain and symptom burden.

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 is a clinical practice guideline for the diagnosis, staging, and treatment of thyroid carcinoma. Recommendations are stratified by histologic type, namely papillary, follicular, Hürthle cell, medullary, and anaplastic. Primary treatment options and assessment and management after initial treatment is reviewed. Recurrent or persistent disease is also discussed.

This clinical practice guideline reviews diagnosis and management of adenocarcinomas of the exocrine pancreas. Risk factors and genetic predisposition are discussed, and the guideline provides recommendations on screening, diagnosis and staging, and treatment options including systemic therapy, chemoradiation, and surgical management. Palliative and supportive care are also reviewed. Topics of interest include an overview of biomarkers, and suggestions for management of premalignant tumours of the pancreas.

This clinical practice guideline provides recommendations on esophageal and esophagogastric junction (EGJ) cancers, including: a review of hereditary cancer predisposition syndromes associated with increased risk for esophageal and EGJ cancers, staging and pathology, imaging, and treatment including surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies. Surveillance, management of metastatic, or recurrent cancer, and best supportive care are also discussed. Special topics of interest include treatment and surveillance options for patients with Barrett's esophagus, and suggested strategies to help alleviate the current problems associated with leucovorin shortage.

This is a clinical practice guideline provides evidence-based recommendations to oncologists and others on potentially curative therapy for patients with localized pancreatic cancer. Key recommendations are guided by questions including: what initial assessment is recommended before initiating any therapy for potentially curable pancreatic cancer; what is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone a resection of their primary tumor; and when should palliative care services be initiated for people with pancreatic cancer that is potentially curable by surgery.

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 is a clinical practice guideline for patients over 18 years of age with esophageal cancer, including both squamous cell and adenocarcinoma. The guideline provides recommendations on diagnostic work-up, staging, treatment options for potentially curable cancer stratified by stage, and management options for incurable cancer. Esophagectomy, endoscopic therapy, primary chemoradiotherapy, radiotherapy, pre-operative chemoradiotherapy followed by esophagectomy and pre-operative chemotherapy are discussed, as well as supportive care. Outcomes of interest include survival (overall, progression-free, 5-year), morbidity, toxicity, and rate of sudden death.

This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline reviews the use of pre- and post-operative therapy including chemotherapy and radiotherapy as treatment options. Outcomes of interest include survival (overall, cause-specific), quality of life, acute and late toxicities, and postoperative morbidity (within 30 days of surgery).

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 guideline addresses diagnostic and therapeutic aspects of thyroid nodular disease; thyroid cancer management is not addressed. The guideline provides recommendations on clinical evaluation and diagnosis, thyroid ultrasonography and other imaging studies, thyroid biopsy, laboratory evaluation, radionuclide scanning, and management and therapy of nodules. Special topics of consideration are thyroid nodules during pregnancy and management of thyroid nodules in children.