Cancer Guidelines Database

This is a clinical practice guideline for patients undergoing potentially cardiotoxic oncological treatment, including chemotherapy, targeted therapy and radiotherapy. The guideline examines various prevention, detection, treatment and monitoring strategies available for reducing cardiovascular toxicity in these patients. Outcomes of interest include cardiovascular morbidity, and mortality.

This is a clinical practice guideline for patients with lung cancer, especially adenocarcinoma. The guideline examines low-dose CT (LDCT) screening of these patients, including the accuracy of LDCT protocols and imaging modalities, and the benefits and risks of LDCT. Risk factors, nonsolid nodules, cost-effectiveness, and the selection of individuals for screening based on risk factors are also discussed.

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 adults and children experiencing cancer-related fatigue (CRF). The guideline discusses screening for CRF, as well as evaluation approaches using focused history, assessment of treatable contributing factors, and patient clinical status. General strategies for managing CRF are discussed, and the guideline examines pharmacological and non-pharmacological treatments for patients based on their placement within the care continuum (i.e. active treatment, post-treatment, and end-of-life).

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 on BReast CAncer gene-related (BRCA-related) cancer in adult patients. The guideline examines risk assessment, genetic counseling and genetic testing in previously undiagnosed and asymptomatic patients as well as those who have a previous diagnosis of breast, ovarian, tubal or peritoneal cancer who have completed treatment and are considered cancer-free. Outcomes of interest include the incidence of BRCA-related cancer, as well as cause-specific and all-cause mortality.

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 the nutritional management of adult patients with head and neck cancer. The guideline examines appropriate access to nutritional care (screening and assessment), quality nutrition care and nutrition monitoring and evaluation. Outcomes of interest include treatment response, reduced adverse related consequences of malnutrition, and quality of life. 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 adult patients with lung cancer. Key areas discussed include screening and early detection, diagnostic procedures for non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), staging, and management strategies. 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 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 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 lung cancer screening in adult patients. The guideline discusses the risk factors for lung cancer, selection of individuals for screening based on level of risk, and the benefits and risks of lung cancer screening. The accuracy of low-dose computed tomography (LDCT), multiple nonsolid nodules, and the concept of shared decision-making are also considered, along with the cost-effectiveness of screening.

This is a clinical practice guideline for patients with non-muscle-invasive bladder cancer. The guideline examines the diagnosis, staging and classification, prediction of disease recurrence and progression, management, and follow-up of these patients. Specific management topics discussed include adjuvant treatment, treatment for failure of intravesical therapy, and radical cystectomy. Counselling of smoking cessation is also discussed.

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 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 developed for adult men who have elected to participate in an early prostate cancer detection program. The guideline provides a set of sequential recommendations detailing screening and evaluation strategies for maximizing the detection of prostate cancer that is effectively treatable and that, if left undetected, represents a risk to the patient. Several techniques designed to improve the identification of significant cancer, while avoiding the detection of indolent disease, are highlighted, including imaging, biomarker testing, and biopsy.

This is a clinical practice guideline for patients with cancer of the uterine cervix, including those with squamous cell carcinomas, adenocarcinomas and adenosquamous carcinomas. The guideline examines screening, diagnosis, staging, treatment, and follow-up of these patients. Specific topics discussed include investigations of abnormal pap smears, investigations for staging, estrogen replacement therapy, 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 guideline for the prevention, screening/early detection, diagnosis, staging, and management of breast cancer. Management options for early invasive breast cancer, stage I or II tumours, locally advanced breast cancer, inflammatory breast cancer, locoregional recurrence, metastatic breast cancer and special circumstances in breast cancer patients are discussed. 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 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 on cervical cancer screening. This guideline provides recommendations regarding screening intervals, the appropriate management of screen-detected abnormalities, screening in specific populations and abnormal vaginal bleeding. Outcomes of interest include cervical cancer mortality, cervical cancer diagnosis and precancerous high grade lesion detection. 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 who have been diagnosed with melanoma, and those who are at high risk for melanoma. The guideline provides recommendations on prevention, screening of high risk individuals, diagnosis, staging, treatment, and follow-up. Treatment strategies explored include surgery, radiation therapy, and adjuvant chemotherapy, and recommendations are separated based on disease type. 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 guideline for the prevention, screening/early detection, diagnosis, staging, and management of endometrial cancer. Management options examined include surgery, adjuvant therapy (e.g. pelvic radiotherapy, chemotherapy), and estrogen replacement therapy. Recommendations for follow-up are presented based on the type of treatment chosen. 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 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 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 adults and children with tumours or hematological cancers who are undergoing chemotherapy and/or other systemic therapies. The guideline provides recommendations for influenza vaccination in these patients. Outcomes of interest include post-vaccine frequency of immune-related adverse events, other infection-related adverse events, and mortality.

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 patients with small cell lung cancer. The guideline examines the diagnosis, staging, prognostic factors, treatment, and surveillance of these patients. Treatment options discussed include systemic therapy, radiotherapy, and surgical resection. Systemic therapy is further examined in elderly patients, and as a second-line (and beyond) treatment. Radiotherapy treatments considered include thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy.

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 prostate cancer. The guideline examines various treatment options including active surveillance, radical prostatectomy, radiation therapy, other local therapies, androgen deprivation therapy, chemotherapy, and immunotherapy. It also discusses risk stratification, imaging, and estimates of life expectancy. Recommendations are provided for the initial diagnosis, clinical assessment, and staging evaluation, as well as for treatment, which are based on both the level of risk, and specific disease present.

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 adult patients with keratinocyte cancer (KC). The guideline examines the prevention, screening, diagnosis, treatment, and follow-up of these patients. Treatment options considered include surgery, radiotherapy, cryotherapy, topical treatments, and photodynamic therapy. Organ transplantation and conditions associated with immunosuppression are also discussed, as are systemic therapies for metastatic disease, the role of primary care, the economics of KC, and common concerns raised by patients. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of January 15, 2020.

This is a clinical practice guideline on the use of transrectal ultrasound (TRUS)-guided biopsy for the diagnosis of prostate cancer. Pre-biopsy procedures, post-biopsy complications, and techniques used during biopsy are all addressed. Outcomes of interest include patient safety, dignity, and comfort.

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 for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.

This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.

This is a clinical practice guideline for patients with prostate cancer. The guideline examines the diagnostic evaluation, classification and staging, treatment, and follow-up of these patients. Treatment for metastatic prostate cancer and castration-resistant prostate cancer are specifically discussed, as is the management of prostate-specific antigen-only recurrence after treatment with curative intent.

This is a clinical practice guideline for patients with sarcoma or connective tissue tumours, including bone tumours. The guideline provides recommendations addressing prevention, diagnosis, staging, management, and follow-up. Diagnostic pathology, as well as treatment through chemotherapy, radiotherapy, and surgery are specifically discussed. 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 presenting to primary care services with signs and/or symptoms of lung cancer. The guideline examines the referral process for this patient population. Topics of interest include factors that have been shown to increase the risk of lung cancer, symptoms that should be present in a person before referral, indications for chest computed tomography (CT) scan, and follow-up to diagnostic investigations.

This is a clinical practice guideline for the screening and early diagnosis of breast cancer in Brazil. The guideline examines various early detection strategies stratified by age bracket and periodicity. The primary outcome of interest is the improvement in breast cancer detection, based on the optimization of program specificity and sensitivity.

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 on the screening for cervical cancer. The guideline examines the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies. Specific strategies discussed include screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years, screening every 3 years with cervical cytology alone, screening every 5 years with high-risk human papillomavirus (HPV) testing alone, and screening every 5 years with high-risk HPV testing in combination with cytology (co-testing) in women aged 30 to 65 years.

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 women at very high risk for breast cancer. The guideline examines the effectiveness of screening using magnetic resonance imaging (MRI) in these patients, in addition to standard screening (mammography). Optimal frequency of MRI screening, subgroups that may benefit more from MRI screening, and associated harms are discussed. Workup and follow-up are also considered for those patients who have abnormal findings seen only on MRI imaging.

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 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 patients with malignant pleural mesothelioma (MPM). The guideline provides recommendations on the investigation of suspected MPM, and the subsequent care and management of individuals with proven MPM. Topics of interest include the preferred investigation pathway of suspected cases of MPM, biomarkers, and the role of different treatments including chemotherapy.

This is a clinical practice guideline for adolescents and young adults with cancer. The guideline discusses risk factors, screening, diagnosis, management, follow-up, supportive care, and palliative care for patients between 15 and 39 years of age. Unique issues discussed include adherence to treatment, the impact of cancer and its treatment on fertility, management of cancer during pregnancy, relationship management, and socioeconomic issues.

This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.

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 with small cell lung cancer. The guideline examines the diagnosis, staging, prognostic factors, treatment, and surveillance of these patients. Treatment options discussed include systemic therapy, radiotherapy, and surgical resection. Systemic therapy is further examined in elderly patients, and as a second-line (and beyond) treatment. Radiotherapy treatments considered include thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy.

This is a clinical practice guideline for adult patients with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. Recommendations are provided for screening, staging, diagnosis, treatment, and follow-up. Treatment options discussed include debulking surgery, chemotherapy, and radiation therapy. Management of drug reactions is also discussed.

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 who are at risk of developing lung cancer. The guideline examines the appropriateness of screening for lung cancer in patient populations based on their smoking history and other risk factors, including radon exposure, occupational exposure to asbestos or other carcinogens, personal history of cancer, family history of lung cancer, history of chronic obstructive pulmonary disease (COPD), and history of pulmonary fibrosis. Screening procedures discussed include chest computed tomography (CT), chest magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography / computed tomography (FDG-PET/CT) from the skull base to mid-thigh, and chest radiography. Information on relevant radiation levels for these procedures is also provided.

This is a clinical practice guideline for lung cancer screening in adult patients. The guideline discusses the risk factors for lung cancer, selection of individuals for screening based on level of risk, and the benefits and risks of lung cancer screening. The accuracy of low-dose computed tomography (LDCT), multiple nonsolid nodules, and the concept of shared decision-making are also considered, along with the cost-effectiveness of screening.

This is a clinical practice guideline on the testing for human papillomavirus (HPV) in patients with head and neck carcinomas. The guideline provides recommendations on the types of head and neck cancer that warrant HPV testing, testing methodologies, and how to report test results. Testing methodologies discussed include immunohistochemistry p16, polymerase chain reaction, and in situ hybridization. Outcomes of interest include negative predictive value and positive predictive value.

This is a clinical practice guideline for adult patients who have been diagnosed with or are suspected of having lymphoma. The guideline discusses Hodgkin lymphoma, as well as the most common non-Hodgkin lymphomas (T-cell and B-cell). Recommendations are provided on diagnosis, staging, treatment, management, and follow up care.

This is a clinical practice guideline developed for adult men who have elected to participate in an early prostate cancer detection program. The guideline provides a set of sequential recommendations detailing screening and evaluation strategies for maximizing the detection of prostate cancer that is effectively treatable and that, if left undetected, represents a risk to the patient. Several techniques designed to improve the identification of significant cancer, while avoiding the detection of indolent disease, are highlighted, including imaging, biomarker testing, and biopsy.

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 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 small cell lung cancer. The guideline examines the diagnosis, staging, prognostic factors, treatment, and surveillance of these patients. Treatment options discussed include systemic therapy, radiotherapy, and surgical resection. Systemic therapy is further examined in elderly patients, and as a second-line (and beyond) treatment. Radiotherapy treatments considered include thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy.

This is a clinical practice guideline for women aged 40-74 who are not at an increased risk for developing breast cancer. The guideline discusses breast cancer screening in this population, and provides specific recommendations on appropriate screening modalities. Recommendations for screening are based on age.

This is a clinical practice guideline for women who have been diagnosed with or are at risk of developing breast cancer. The guideline examines the different methods of diagnosis and screening for breast cancer that will facilitate clinical decision-making. The guideline provides a consistent framework for screening and evaluating a spectrum of clinical breast lesions and takes into consideration different imaging modalities and screening recommendations for women at different levels of risk.

This is a clinical practice guideline for adult patients with active cancer. The guideline examines screening, assessment, and management strategies for cancer-related pain of any severity in these patients. Pharmacological management options discussed include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), adjuvant analgesics, opioid drugs, and management of cancer pain in patients with renal impairment. Non-pharmacological management options including radiotherapy, vertebroplasty and kyphoplasty, anesthetic interventions, surgical interventions, and complementary therapies are also discussed. The guideline also considers supportive care of these patients.

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 patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.

This is a clinical practice guideline for adult men who are at average risk of developing prostate cancer. The guideline examines screening methods for the early detection of prostate cancer for the purpose of reducing mortality. Outcomes of interest include prostate cancer incidence, mortality, quality of life, and the diagnostic performance of each of the tests, including the harms of testing (premature death and complications from both testing and biopsy).

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 asymptomatic adults. The guideline discusses the screening of lung cancer using computed tomography (CT) scans. Different recommendations are provided based on age, as well as smoking status.

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 who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.

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 adults with cancer who are at risk for, or have been diagnosed with, delirium. The guideline provides recommendations regarding delirium prevention, diagnosis, screening, treatment and experiential impact. Pharmacological and non-pharmacological interventions are discussed. Guidance is also provided on education and support for the healthcare team and family members.

This is a clinical practice guideline for children with suspected or confirmed transient leukemia of Down syndrome (TL-DS). The guideline examines the clinical features and diagnosis of TL-DS, outcomes, risk factors for early death, and treatment of TL-DS, as well as monitoring for resolution of TL-DS and development of myeloid leukemia of Down syndrome (MI-DS). Fetal TL-DS, silent TL-DS and screening for mutations in the hematopoietic transcription factor gene GATA1 are also discussed.

This is a clinical practice guideline for lung cancer screening in adult patients. The guideline discusses the risk factors for lung cancer, selection of individuals for screening based on level of risk, and the benefits and risks of lung cancer screening. The accuracy of low-dose computed tomography (LDCT), multiple nonsolid nodules, and the concept of shared decision-making are also considered, along with the cost-effectiveness of screening.

A clinical practice guideline on the diagnosis, work-up, and treatment of patients who have been diagnosed with or are suspected of having primary cutaneous B-cell lymphomas (PCBCLs). The guideline focuses on the three main types of PCBCLs: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle-center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, leg type). Recommendations for treatment are provided based on lymphoma type and whether treatment is for initial, relapsed, or refractory disease.

This is a clinical practice guideline for asymptomatic men. The guideline discusses the appropriateness of periodic prostate-specific antigen (PSA) based screening for prostate cancer. Recommendations for screening are separated based on patient age.

This is a clinical practice guideline for the prevention and screening of skin cancer. Behavioural counselling recommendations are provided for young adults, adolescents, children, and parents of young children. Outcomes of interest include changes in sun protection behaviours, frequency of sunburn, and frequency of skin cancer.

This is a clinical practice guideline for women with an average risk of ovarian cancer. The guideline examines the benefits and harms of screening for ovarian cancer in these patients, including those of the screening test and of diagnostic evaluation. Screening tests considered include cancer antigen 125 (CA-125) screening and transvaginal ultrasound screening, on their own or combined. Outcomes of interest include ovarian cancer mortality, quality of life, false-positive rates, surgical complication rates, and the psychological effects of screening.

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 that informs primary care clinicians about the potential use of adjuncts to the conventional visual and tactile examination (CVTE) for the evaluation of lesions, including potentially malignant disorders (PMDs), in the oral cavity. The guideline examines the diagnostic test accuracy of cytologic testing, autofluorescence, tissue reflectance, vital staining, and salivary adjuncts. Outcomes of interest include incidence of oral cancer, oral cancer survival, and 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 women with average risk and high risk for ovarian cancer. The guideline examines the role of imaging during ovarian cancer screening, and its effectiveness in detecting ovarian cancer at an early stage, in order to potentially improve survival. Variations of procedures, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography using fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG-PET), are discussed, as is their appropriateness in different clinical situations.

This is a clinical practice guideline for men and adolescents with hematospermia or hemospermia. The guideline discusses imaging techniques such as transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI), and their use in the identification of hematospermia's etiology. The guideline examines the appropriateness of different imaging techniques based on patient age, severity of bleeding, and presence of other relevant symptoms.

This is a clinical practice guideline for asymptomatic Canadian men. The guideline provides recommendations on the current best practices for prostate cancer screening and early diagnosis, and provides information on new and emerging diagnostic modalities.

This is a clinical practice guideline for the appropriate use of breast magnetic resonance imaging (MRI). The guideline examines indications for breast MRI use, such as for the screening of high risk individuals, for problem solving when mammographic, sonographic or clinical findings are suspicious but inconclusive, for the assessment of positive margins following breast cancer surgery or neoadjuvant chemotherapy, and for the assessment of breast implant integrity.

This is a clinical practice guideline for patients with uterine corpus cancer. These guideline discusses screening, surgery, adjuvant treatment, and advanced and recurrent disease with respect to endometrial carcinoma and uterine sarcoma. Other topics of interest include lymphadenectomy, fertility-sparing treatment, chemotherapy, and hormonal therapy.

This is a clinical practice guideline for the management of patients with advanced breast cancer (ABC), including those with locally advanced breast cancer (LABC) and metastatic breast cancer (MBC). The guideline provides recommendations for the management of these patients, and specifically discusses the use of chemotherapy, management of bone metastases, management of cancer related fatigue, as well as supportive and palliative care.

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 management of urothelial carcinoma of the upper urinary tract (UTUC). The guideline provides recommendations on diagnosis, staging, treatment, and follow-up. Prognostic factors, predictors of survival and recurrence, as well as risk stratification are also discussed. Outcomes of interest include diagnostic accuracy, overall survival, recurrence rates, and adverse effects.

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 clinical practice guideline is an endorsement of the American Thyroid Association's 2015 guideline titled Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. The guideline provides recommendations on management of patients thyroid nodules and differentiated thyroid cancers. Topics include evaluation of thyroid nodules to determine the presence of malignancy, and management of differentiated thyroid cancer including surgery, radioactive iodine (RAI) therapy, hormonal therapy, external beam radiation therapy (EBRT), and systemic treatment.

This is a clinical practice guideline for patients at high risk for developing hereditary breast cancer. The guideline examines the breast screening protocol for these patients. Recommendations are provided on the frequency and age of initiation for mammography screening and breast MRI, as well as the timing of breast MRI in the menstrual cycle. Criteria for determining patients who are at high risk of developing hereditary breast cancer are also provided.

This is a clinical practice guideline for adults with cancer-related fatigue. The guideline examines the appropriate screening, assessment, and management of these patients. Interventions discussed include pharmacological management, physical activity, functional and occupational therapy interventions, psychosocial and educational interventions, complementary therapies, nutrition, and management of anemia. Recommendations are provided based on the severity of fatigue.

This is a clinical practice guideline for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.

This is a clinical practice guideline for screening women who may be at risk of having breast cancer. The guideline examines effective screening methods, particularly focusing on mammography, digital breast tomosynthesis (DBT), magnetic resonance imaging (MRI), and ultrasound (US). Outcomes of interest include disease progression, screening sensitivity, and screening accuracy.

A clinical practice guideline for asymptomatic, nonpregnant adult women. The guideline discusses pelvic examination as a screening method for gynecological conditions such as bacterial vaginosis, candidiasis, genital warts, genital herpes, trichomoniasis, pelvic inflammatory disease, cervical polyps, endometriosis, ovarian cysts, dysfunction of the pelvic wall and floor, and uterine fibroids, in addition to ovarian, uterine, and vaginal cancer. This guideline does not address the screening of cervical cancer, gonorrhea, or chlamydia.

This is a clinical practice guideline for patients with epithelial ovarian-type cancers (e.g. ovary, fallopian tube or peritoneal origin) and borderline tumours. This guideline addresses epithelial cancers of varying histological subtypes. The guideline covers the full continuum of care including screening and prevention, diagnosis, treatment options such as surgery, systemic therapy and chemotherapy, follow-up, as well as management of recurrent disease. The guideline also highlights the support needs for women with ovarian cancer.

This is a clinical practice guideline for adult patients who may be at risk for developing breast cancer. The guideline examines breast cancer screening for this patient population at different levels of risk. Different screening options such as mammography, ultrasound, magnetic resonance imaging, and tomosynthesis are discussed.

This is a clinical practice guideline for patients with cutaneous melanoma. The guideline examines the care of these patients throughout the cancer care continuum, including prevention and surveillance, diagnosis and prognosis, surgical management and staging, further investigations and non-surgical staging, adjuvant treatment of stage 2 and 3 melanoma, follow up of patients with stage 1, 2 and 3 melanoma, and management of advanced (unresectable stage 4 or 5) melanoma.

This is a clinical practice guideline for women with uterine cancer. The guideline provides recommendations for the screening and prevention of uterine cancer in the general population and in high risk groups, as well as for the pathological work-up, management, and follow-up of patients with uterine cancer. Specific conditions discussed include endometrioid endometrial cancer, as well as non-endometrioid cancers such as uterine serous carcinoma, uterine clear cell carcinoma, and uterine carcinosarcoma.

This is a clinical practice guideline for the management of non-muscle-invasive bladder cancer. Recommendations are provided for diagnosis, staging, treatment, and follow-up. The guideline also discusses how to predict the short-term and long-term risks of disease recurrence and progression, as well as the stratification of patients into risk groups. Treatment options are presented based on these risk groups. Management of side effects is also discussed.

This is a clinical practice guideline for the screening and treatment of thyroid cancer in asymptomatic adults. The guideline examines the accuracy of screening for thyroid cancer, and the harms of screening and/or treating thyroid cancer, such as overdiagnosis. Outcomes of interest include thyroid-specific morbidity and mortality, general mortality, and quality of life.

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 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 lung cancer screening in adult patients. The guideline reviews risk factors for lung cancer and provides recommendations on selecting high-risk individuals for screening, guidance on choice of screening modalities with specific review of low dose computed tomography (LDCT), and recommendations on the evaluation and follow-up of nodules found during screening. Additionally, the benefits and risks of screening are discussed.

This is a clinical practice guideline for adult patients with prostate cancer. The guideline examines the screening, diagnosis, staging, treatment, and follow-up of these patients. Treatment options considered include deferred treatment, radical prostatectomy, definitive radiotherapy, and hormonal therapy. Management of metastatic prostate cancer, prostate cancer in older men, prostate-specific antigen-only recurrence after treatment, and castration-resistant prostate cancer are also discussed, as well as the epidemiology and etiology of prostate cancer, and quality of life outcomes.

This is a clinical practice guideline for adolescents and young adults with cancer. The guideline discusses risk factors, screening, diagnosis, management, follow-up, supportive care, and palliative care for patients between 15 and 39 years of age. Unique issues discussed include adherence to treatment, the impact of cancer and its treatment on fertility, management of cancer during pregnancy, relationship management, and socioeconomic issues.

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 adult patients with non-small cell lung cancer. The guideline provides updated recommendations around prevention and screening, evaluation and staging, treatment, and follow up care. Areas of focus are discussed with recognition that much progress has been made in regards to screening, minimally invasive techniques for diagnosis and treatment, advances in radiation therapy (RT) including stereotactic ablative radiotherapy (SABR), and targeted therapies.

This is a clinical practice guideline for breast cancer screening. The guideline provides recommendations based on three different variants: 1. high-risk women (women with a BRCA mutation and their untested, first-degree relatives, women with a history of chest irradiation between the ages of 10-30, women with 20% or greater lifetime risk of breast cancer); 2. intermediate-risk women (women with personal history of breast cancer, lobular neoplasia, atypical ductal hyperplasia, or 15-20% lifetime risk of breast cancer); 3. average-risk women (women with <15% lifetime risk of breast cancer, breasts not dense). Recommendations consider the appropriateness of mammography, digital breast tomosynthesis (DBT), magnetic resonance imaging (MRI), ultrasound, as well as other imaging modalities.

A clinical practice guideline for middle-aged and older men at risk for prostate cancer who are considering, or have decided to have, a PSA test. The guideline examines supporting informed decision making for PSA testing, recommended protocols, and diagnosis and management for abnormal results. Outcomes of interest include reducing over-diagnosis and improved cumulative mortality.

This clinical practice guideline is an adoption of the American College of Physicians' 2014 guideline title Screening Pelvic Examination in Adult Women: A Clinical Practice Guideline from the American College of Physicians. The guideline examines the use of pelvic examinations to screen for noncervical cancer, pelvic inflammatory disease, or other benign gynecologic conditions in asymptomatic, non-pregnant adult women. Speculum or bimanual examinations are specifically discussed; the use of Pap tests for cervical cancer screening is not addressed in this guideline.

This is a clinical practice guideline for individuals at risk of or having genetic mutations that increase their risk of breast or ovarian cancer. The guideline reviews hereditary breast or breast/ovarian cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome/PTEN Hamartoma tumor syndrome, and other genetic mutations associated with breast/ovarian cancer. Recommendations are provided for initial risk assessment, formal risk assessment and genetic counselling, and management options for individuals with a clinical diagnosis following genetic testing.

This is a clinical practice guideline for the management of chronic pain in survivors of adult cancers. Whereas other guidelines have largely focused on relieving acute pain or pain associated with advanced disease, this guideline focuses on the care required when pain persists months or years after the completed cancer treatment. Areas addressed in the guideline include: screening and comprehensive assessment; treatment and care options; nonpharmacologic interventions; pharmacologic interventions; as well as risk assessment, mitigation, and universal precautions with opioid use.

A clinical practice guideline for adults with locally advanced, high-risk prostate cancer. The guideline examines aggressive approaches to prostate cancer treatment, focusing on intensive local therapy through external beam radiation. Outcomes of interest include improved local control resulting in improved outcomes via combination therapy.

A clinical practice guideline for lung cancer screening of adults at high risk. The guideline examines computed tomography screening and screening intervals, and criteria for high risk screening. Outcomes of interest include reduction in harms from chest radiography and improved screening economy.

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.

A clinical practice guideline for women who may be at risk for breast cancer or who qualify for breast cancer screening. The guideline examines screening for average and increased risk, and diagnostic evaluation including mammography, MRI, ultrasound, and tissue biopsy. Outcomes of interest include adverse events, delayed diagnosis, and probability of malignancy.

This is a clinical practice guideline for patients who have undergone allogenic hematopoietic stem cell transplantation (HSCT). The guideline examines the prevention, diagnosis and management of post-lymphoproliferative disorders caused by Epstein-Barr virus (EBV) infections in these patients. Outcomes of interest include the sensitivity and specificity of tests that detect EBV-related post-transplant lymphoproliferative disorders, and the reduction of morbidity and mortality in patients undergoing HSCT.

This is a clinical practice guideline for the screening of skin cancer in asymptomatic adults. The recommendations do not apply to patients with suspicious skin lesions, family history of skin cancer, or personal history of pre-malignant or malignant skin lesions. Outcomes of interest include reductions in morbidity and mortality from skin cancers.

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 management of viral hepatitis in patients with hematological malignancy and in patients undergoing haemopoietic stem cell transplantation. The guideline examines the screening, vaccination, and treatment options for these conditions. Primary outcomes of interest include the prevention of viral reactivation, and increasing overall survival.

This is a clinical practice guideline for women who are at risk of developing cervical cancer. The guideline examines the optimal methods for cervical cancer screening and the management of women with abnormal screening results. Primary screening, exiting screening, triage and post-triage time periods, and the treatment of women with precursor lesions are all discussed. Different recommendations are provided based on economic resource level (i.e., basic, limited, enhanced or maximal).

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.

The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. The guideline provides recommendations for management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment.

These clinical practice guidelines for survivorship provide screening, evaluation, and treatment recommendations for common consequences of cancer and cancer treatment to aid health care professionals who work with survivors of adult-onset cancer in the post-treatment period, including those in specialty cancer survivor clinics and primary care practices. The guidelines focus on the vast and persistent impact both the diagnosis and treatment of cancer can have on the adult survivor’s health, physical and mental states, health behaviors, professional and personal identity, sexuality, and financial standing.

This is a clinical practice guideline for healthy male patients who have elected to participate in early screening of prostate cancer. The guideline reviews types of early detection testing, mainly PSA and DRE, provides recommendations on baseline evaluation, risk assessment, and early detection evaluation, provides guidance on indications for biopsy and direction for management of biopsy results. Special topics of interest include biomarker testing and biopsy technique.

A clinical practice guideline for patients with a history of breast cancer. The guideline examine the use of biopsies and retesting of estrogen receptor (ER), progesterone receptor (PR) and HER2-neu receptor (HER2) to determine recurrence or metastases. Outcomes of interest include progression-free and overall survival.

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 guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing. Provincial resources are provided.

This is a clinical practice guideline for stage I breast cancer, and focuses specifically on the initial workup and surveillance for local recurrence and distant metastases in asymptomatic women. Recommendations are made with different variants in mind, including newly diagnosed cases, surveillance, and ruling out brain metastases, liver metastases, and thoracic metastases. The guideline also considers the appropriateness of different imaging procedures to detect or rule out metastasis.

This is a clinical practice guideline for breast pain. Recommendations are made with consideration of the two main types of breast pain: 1. cyclical breast pain (diffuse unilateral or bilateral pain and/or tenderness, often accompanied by swelling, that waxes and wanes with the menstrual cycle); 2. noncyclical breast pain (predominantly inflammatory in nature, rather than hormonal in origin. It is usually unilateral, and tends to be more focal than cyclical breast pain). The guideline provides guidance on the examination of breast pain with recommendations considering different types of imaging options.

This is an update of the 2009 recommendation on screening for breast cancer. The recommendations apply to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as BRCA1 or BRCA2 gene mutation or other familial cancer syndrome) or a history of chest radiation at a young age. The recommendations consider the benefits of screening mammography and digital breast tomosynthesis (DBT) as well as the potential harms.

This is a clinical practice guideline for the screening of breast cancer in asymptomatic women. Different screening modalities are compared, such as mammographic screening with clinical breast examination, clinical breast examination, and ultrasonography with and without mammography. Age-based recommendations are made regarding the most appropriate screening modalities.

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 screening and treatment of precancerous lesions for cervical cancer prevention. The guideline focuses specifically on the screening for cervical intraepithelial neoplasia 2 & 3 and the treatment of those lesions to prevent cervical cancer in women who tested positive after screening. In formulating the recommendations, the guideline authors specifically took into account resource implications in the Saudi context.

A clinical practice guideline for patients with suspected uterine neoplasms. The guideline examines surveillance, diagnostic assessment, and treatment focusing primarily on surgical interventions and systemic therapy. Outcomes of interest include long-term survival and reproductive sparing.

This clinical practice guideline is for adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, who have been diagnosed with cancer. The guideline discusses issues specific to AYAs and recommends interventions unique to these patients. Topics include an overview of risk factors, screening, diagnosis, and special considerations for management of AYA patients such as adherence to treatment and fertility preservation, contraception for women during and after cancer treatment, and management of cancer during pregnancy. Psychosocial and behavioural issues, survivorship issues, and palliative and end-of-life care are 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 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 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 is a clinical practice guideline for adult patients with thyroid nodules and differentiated thyroid cancer (DTC). The guideline provides recommendations on initial management of thyroid cancer including screening, staging, risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression therapy using levothyroxine, as well as long-term management including surveillance techniques, management of recurrent and metastatic disease, and consideration for clinical trials and targeted therapy. The evaluation and diagnostic approach for thyroid nodules is also discussed, including a review of indications for fine-needle aspiration biopsy and interpretation of results, as well as use of molecular markers and management of benign thyroid nodules. Outcomes of interest include survival, recurrence, sensitivity and specificity.

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 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.

A clinical practice guideline for radiologic management of thoracic nodules and masses. The guideline examines radiologic imaging and lung cancer screening, focusing primarily on CT scans and biopsy for a number of variant conditions. Outcomes of interest include diagnostic accuracy, reduced thoracotomies, and reduced complications.

A clinical practice guideline for screening mammography in women at average risk for breast cancer. The guideline examines screening regularity and the relative benefits and harms of screening modalities, focusing primarily on mammography. Outcomes of interest include reduced harm through false-positives and improved breast cancer mortality.

This guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing.

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 management of prostate cancer, including diagnosis and screening, management stratified by risk, and follow up care. Active surveillance, surgery (radical prostatectomy), external beam radiotherapy (EBRT), low dose rate (LDR) brachytherapy, cryosurgery, High Intensity Focused Ultrasound (HIFU), Androgen Deprivation Therapy (ADT), and systemic therapies are discussed as treatment options. Bone health is also reviewed. Outcomes of interest include survival and recurrence.

This is a clinical practice guideline fore patients who have been diagnosed with or are at risk of developing non-small cell lung cancer (NSCLC). The guideline provides recommendations on disease prevention and screening, including risk factors, the role of smoking cessation, and screening programs for early diagnosis. Recommendations regarding clinical presentation are also presented, with specific topics such as imaging studies, and surgical risk, including cardiological risk and the evaluation of respiratory function. The guideline also provides guidance on follow-up, when appropriate.

A clinical practice guideline for the management of patients with non-small cell lung cancer. The guideline examines screening for at-risk populations, diagnostic work-up, treatment, and follow-up. Outcomes of interest include clarified current standard of care through lobectomy and mediastina lymph node dissection, with additional treatment selections based on patient population.

A clinical practice guideline for the surveillance of patients following treatment for uveal melanoma and the use of new and systemic treatments. The guideline examines the effectiveness of new surveillance technologies, staging, and treatment including special consideration for patients with hepatic recurrence. Outcomes of interest include local tumour control, preservation of eye function, and progression free survival.

This clinical practice guideline is for adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, who have been diagnosed with cancer. The guideline discusses issues specific to AYAs and recommends interventions unique to these patients. Topics include an overview of risk factors, screening, diagnosis, and special considerations for management of AYA patients such as adherence to treatment and fertility preservation, contraception for women during and after cancer treatment, and management of cancer during pregnancy. Psychosocial and behavioural issues, survivorship issues, and palliative and end-of-life care are also discussed.

This is a clinical practice guideline for the prevention and management of venous thromboembolism (VTE) in patients with cancer. The guideline also provides guidance on an approach to screening for cancer in patients with unprovoked VTE in whom cancer was not initially suspected based on clinical grounds. The guideline probes the association between cancer and thrombosis, with areas of interest including the prevention of catheter-related thrombosis, treatment of symptomatic cancer-associated VTE, and screening for cancer in patients with apparently unprovoked VTE.

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.

This is a clinical practice guideline for the screening, assessment and management of cancer-related fatigue in adults. The guideline examines the efficacy of interventions (pharmacological, non-pharmacological, and/or combinations) for reducing cancer-related fatigue in adults and comparisons are made to usual care and attention control. Outcomes of interest include clinically significant improvement in fatigue or clinically significant reduction in cancer-related fatigue (measured by severity) or differences in fatigue severity between intervention group and controls using self-reported outcome measures.

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 epithelial ovarian cancer. The guideline examines the clinical use of cancer biomarkers in these patients for the purposes of screening, differential diagnosis, prognosis, and monitoring. Biomarkers discussed include cancer antigen 125 (CA125) and human epididymis protein 4 (HE4). Algorithms for calculating the risk of malignancy index (RMI) including the RMI 1, RMI 2, Assessment of Different NEoplasias (adneXa), and risk of ovarian malignancy algorithm (ROMA), are also discussed.

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.

A clinical practice guideline for women who may be at risk for breast cancer. The guideline examines effective screening and diagnosis methods, focusing on mammography with comparisons made to imaging techniques. Outcomes of interest include breast cancer outcomes, screening sensitivity, and accuracy.

This is a clinical practice guideline for healthy male patients who have elected to participate in early screening of prostate cancer. The guideline reviews types of early detection testing, mainly PSA and DRE, provides recommendations on baseline evaluation, risk assessment, and early detection evaluation, provides guidance on indications for biopsy and direction for management of biopsy results. Special topics of interest include biomarker testing and biopsy technique.

This is a clinical practice guideline for adult patients with non-small cell lung cancer. The guideline provides updated recommendations around prevention and screening, evaluation and staging, treatment, and follow up. Areas of focus are discussed with recognition that much progress has been made in regards to screening, minimally invasive techniques for diagnosis and treatment, advances in radiation therapy (RT) including stereotactic ablative radiotherapy (SABR), and targeted therapies.

This is a clinical practice guideline for patients at risk of Birt-Hogge-Dubé Syndrome, the familial atypical multiple mole melanoma syndrome and neurofibromatosis 1&2, either based on clinical suspicion or family history. The guideline reviews indications for genetic testing, clinical utility of specific genetic tests, and follow-up depending on test results and family history. Impact of genetic counselling and test on patient behaviour and distress levels is also reviewed.

This is a clinical practice guideline for patients with Barrett's esophagus (BE) without dysplasia and BE with dysplasia and/or early esophageal adenocarcinoma (EAC). Topics of discussion include: endoscopic and histological definitions of BE and early EAC; prevalence, incidence, natural history, and risk factors for BE and early EAC; and management of BE and early EAC, including modification of lifestyle factors, screening, surveillance, and medical, endoscopic, and surgical interventions.

This is a clinical practice guideline for patients diagnosed with or suspected of having small cell lung cancer. The guideline reviews screening, work-up, and treatment for limited stage and extensive stage cancer. Recommendations are also provided on follow up care.

A clinical practice guideline for the diagnosis and management of primary sclerosing cholangitis and possible development of bile duct and colon cancers. The guideline examines diagnosis through biochemical tests, autoantibodies and imaging as well as the lack of established medical treatments. Outcomes of interest include improved jaundice, reduced hospitalizations, and improved recommendations for reducing colonic malignancy risks.

This is a clinical practice guideline for the diagnosis and management of Barrett's Esophagus (BE). The purpose of this guideline is to review the definition and epidemiology of BE, available screening modalities for BE detection, rationale and methods for surveillance, and available treatment modalities including medical, endoscopic, and surgical techniques. These 2015 guidelines differ markedly from their 2008 predecessor in several areas including: the expanded use of endoscopic ablative therapy, further refinement of screening recommendations, and a better understanding of the impact of gender and anthropomorphics on risk.

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 referral of patients with suspected prostate cancer by family physicians and other primary care providers. More specifically, the guidelines provide recommendations for referral based on digital rectal examination (DRE) findings and prostate-specific antigen (PSA) test results. The research questions that guided the development of recommendations included: what signs, symptoms, and other clinical features that present in primary care are predictive of prostate cancer; what is the diagnostic accuracy of investigations commonly considered for patients presenting with signs and/or symptoms of prostate cancer; and what major, known risk factors increase the likelihood of prostate cancer in patients presenting with signs and/or symptoms of prostate cancer.

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 individuals at risk of or having genetic mutations that increase their risk of breast or ovarian cancer. The guideline reviews hereditary breast or breast/ovarian cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome/PTEN Hamartoma tumour syndrome, and other genetic mutations associated with breast/ovarian cancer. Recommendations are provided for initial risk assessment, formal risk assessment and genetic counselling, and management options for individuals with a clinical diagnosis following genetic testing.

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 clinical practice guideline discusses genetic testing for patients diagnosed with or suspected of having hereditary endocrine cancer syndromes, specifically multiple endocrine neoplasia type 2 (MEN2), multiple endocrine neoplasia type 1 (MEN1), Von Hippel-Lindau (VHL) syndrome, and paraganglioma and phaeochromocytoma. Indications for genetic testing of relatives of patients is also reviewed. Genetic testing for Succinate Dehydrogenase B, C and D (SDHB, SDHC, SDHD), menin, VHL and RET mutations are discussed. Outcomes of interest include diagnostic accuracy, health outcomes, and psychosocial outcomes.

This is a clinical practice guideline for cervical cancer screening for asymptomatic women aged over 20. The guideline committee considered the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing. Other areas of interest addressed in this guideline include: the age to begin and the age to terminate and screening interval; as well as the false-positive and resulting the psychological harms in screening.

This is a clinical practice guideline for the diagnosis and management of medullary thyroid carcinoma (MTC) in both pediatric and adult patients. Recommendations are organized by sections that include: ethical considerations for genetic screening, surgical treatment, treatment of patients with hormonally active metastases, and hormone replacement. Although the guideline group acknowledges that there has been significant advances in the diagnosis and treatment of patients with MTC, they close with a statement around the fact that there is critical need for more effective therapies for patients with advanced MTC.

These clinical practice guidelines for survivorship provide screening, evaluation, and treatment recommendations for common consequences of cancer and cancer treatment to aid health-care professionals who work with survivors of adult-onset cancer in the post-treatment period, including those in specialty cancer survivor clinics and primary care practices. The guidelines focus on the vast and persistent impact both the diagnosis and treatment of cancer can have on the adult survivor’s health, physical and mental states, health behaviours, professional and personal identity, sexuality, and financial standing.