prev.colorectal-screening.v1PRODUCTION

prev.colorectal-screening.v1

Colorectal cancer screening (adult)

general_internal_medicinechronicadult

Hard-required inputs

0 / 7

Care setting:

Encounter flow

12/12 authored

Canonical 12-phase frame with authored status for this dossier.

Current phase

Frame

Detailed

Confirm CRC screening scope: asymptomatic adult age 45-75 (76-85 individualized Grade C; discontinue >85), life expectancy ≥10 yr (below which lead-time + colonoscopy harm + non-advanced-adenoma overdiagnosis > benefit → STOP-screening). Excludes symptomatic workup (hematochezia/iron-def anemia/weight loss → diagnostic, gi.lgib.core.v1) and prior-CRC survivorship surveillance (USPSTF 2021 PMID 34003218)

Inputs

Actions

Advance rule

Set

Advance when

Asymptomatic, age-eligible, ≥10-yr life expectancy confirmed

Patient inputs (11)

age*demographic • CONTEXT

Age sets the pre-test prevalence (the Bayesian prior) and the eligibility window: 45-75 screen, 76-85 individualized, >85 discontinue (USPSTF 2021 PMID 34003218)

prior_colonoscopy_result*history • CONTEXT

not present

Prior colonoscopy date + polyp histology/size/number set the next interval and the conditional post-test prior (USMSTF 2020 PMID 32044092)

life_expectancy_estimate*history • FRAME

not present

Screening benefit requires ≥10-yr life expectancy; below that lead-time + procedure harm + overdiagnosis exceed benefit → STOP-screening (USPSTF 2021)

hereditary_crc_syndrome*history • RED_FLAGS

not present

Lynch (MMR — CRC lifetime ~50-80%) / FAP (APC near-100%) set a very high prior → earlier + far more frequent colonoscopy, different protocol (NCCN 2024)

alarm_gi_symptoms*symptom • RED_FLAGS

Hematochezia, iron-deficiency anemia, unexplained weight loss, change in bowel habit = NOT screening — exit to diagnostic workup / gi.lgib.core.v1 (test-characteristic context changes entirely)

family_hx_crc*history • RISK_STRATIFICATION

not present

First-degree relative with CRC/advanced adenoma raises the prior and shifts start age/interval (start 40 or 10y before youngest dx, colonoscopy q5y) (USMSTF 2017)

ibd_status_duration_extent*history • RISK_STRATIFICATION

not present

IBD colitis duration/extent sets the dysplasia-surveillance prior (surveillance from 8 yr post-pancolitis dx, q1-3y) — NOT the average-risk interval (USMSTF)

fit_resultlab • BRANCHING_WORKUP

FIT pooled sens ~0.79 / spec ~0.94, LR+ 13.10; a positive FIT raises post-test probability enough to mandate diagnostic colonoscopy (Lee Ann Intern Med 2014 PMID 24658694)

fit_dna_resultlab • BRANCHING_WORKUP

Multitarget stool DNA CRC sens 92.3% but spec 86.6% — positive → diagnostic colonoscopy; lower spec = more false-positive colonoscopies (Imperiale NEJM 2014 PMID 24645800)

pregnancy_statushistory • CONTEXT

Pregnancy defers non-urgent colonoscopy/CTC (radiation) — special-population branch; FIT may be deferred and resumed postpartum

prior_crc_survivorhistory • CONTEXT

not present

Prior-CRC survivors follow survivorship surveillance, not average-risk screening — different prior + protocol (route out)

* = hard-required. Engine cannot meaningfully run until these are filled.

Severity triggers (7)

7 need judgement

informationalseverepositive_noncolonoscopy_test_high_PPV_route_to_diagnostic_colonoscopy — Lee/Imperiale
Positive FIT (LR+ ~13.10 — Lee PMID 24658694), positive FIT-DNA (CRC sens 92.3% — Imperiale PMID 24645800), positive flexible sigmoidoscopy, or incomplete/positive CTC — post-test probability now high enough that the harm of NOT working up exceeds the harm of the diagnostic colonoscopy
Trigger could not be auto-evaluated — needs clinician judgement.
informationalseverehereditary_crc_syndrome_confirmed — NCCN 2024
Confirmed Lynch (MLH1/MSH2/MSH6/PMS2 — CRC lifetime ~50-80%) or FAP (APC, near-100% CRC) — very high prior requiring earlier + far more frequent colonoscopy; Lynch adds aspirin chemoprevention (CAPP2 CRC HR 0.65 — PMID 32534647)
Trigger could not be auto-evaluated — needs clinician judgement.
informationalseverealarm_symptoms_are_diagnostic_not_screening_exit — ACG
Hematochezia, iron-deficiency anemia, unexplained weight loss, or obstructive change in bowel habit — the patient is symptomatic; this is NOT screening (the pre-test prevalence and test characteristics no longer apply) → exit to diagnostic colonoscopy / gi.lgib.core.v1
Trigger could not be auto-evaluated — needs clinician judgement.
informationalmoderaterisk_tier_crosses_action_threshold_intensify_interval — NCCN/USMSTF
FDR-CRC (start 40 or 10y before youngest dx, q5y), Lynch (colonoscopy q1-2y from 20-25), FAP (annual from 10-15), or IBD (surveillance from 8y post-pancolitis dx, q1-3y) — the risk-tier prior crosses the action threshold and changes start age + interval + modality
Trigger could not be auto-evaluated — needs clinician judgement.
informationalmoderatefalse_positive_cascade_and_overdiagnosis_harm — NordICC/Imperiale
A positive screen in a low-prior context is more likely false-positive (FIT diet/NSAID cross-reactivity; FIT-DNA spec 86.6% vs FIT 94.9% = more unnecessary colonoscopies — Imperiale PMID 24645800) or detects a non-advanced adenoma of limited clinical significance; colonoscopy harm (NordICC 15 major bleeds / ~11,843 screened — PMID 36214590) is the harm side of the Bayesian ledger
Trigger could not be auto-evaluated — needs clinician judgement.
informationalmildpretest_prevalence_below_testing_threshold_do_not_screen — USPSTF 2021
Age <45 average-risk, life expectancy <10 yr, or age >85 — pre-test prevalence × harm of colonoscopy cascade + non-advanced-adenoma overdiagnosis exceeds expected benefit; age 76-85 is the individualized borderline band (Grade C)
Trigger could not be auto-evaluated — needs clinician judgement.
informationalmildstop_screening_life_expectancy_or_age_bound — USPSTF 2021
Life expectancy <10 yr OR age >85 (discontinue), or age 76-85 individualized (Grade C) — the deprescribing-equivalent
Trigger could not be auto-evaluated — needs clinician judgement.

Workflow calculators

This dossier does not reference any calculators.

Recommended regimen

Colorectal — colonoscopy / FIT / FIT-DNA / CTC / flex-sig (USPSTF 2021 Grade A/B PMID 34003218; ACS 2018 PMID 29846947)

axis: screening_modality_colorectal

Selected axis "Colorectal — colonoscopy / FIT / FIT-DNA / CTC / flex-sig (USPSTF 2021 Grade A/B PMID 34003218; ACS 2018 PMID 29846947)" by default fallback (first axis)

colonoscopy_q10yr
first line
endoscopy_screen
Colonoscopy q10yr, age 45-75 average-risk • procedure • q10yr
Adenoma sens ~95% (reference standard). NordICC (Bretthauer NEJM 2022 PMID 36214590): ITT 10-yr CRC risk 0.98% vs 1.20% (RR 0.82, 95% CI 0.70-0.93), NNT-invite 455, CRC-death RR 0.90 (95% CI 0.64-1.16, NS at 10y — ITT dilution, 42% screened). Harm: 15 major bleeds / ~11,843 screened, no perforations/deaths ≤30d. USPSTF 2021 Grade A 50-75 / B 45-49.
fit_annual
first line
stool_screen
FIT annually, age 45-75 • lab • annual
Pooled sens 0.79 (95% CI 0.69-0.86) / spec 0.94 (0.92-0.95), LR+ 13.10, LR− 0.23 — Lee Ann Intern Med 2014 PMID 24658694; cutoff-dependent (sens 0.89 at <20 µg/g). A positive FIT raises post-test probability enough to mandate diagnostic colonoscopy.
fit_dna_stool_test_q1_3yr
second line
stool_screen
Multitarget stool DNA (FIT-DNA / Cologuard) q1-3yr • lab • q1-3yr
triggers: patient_preference_noninvasive, fit_declined
CRC sens 92.3% vs FIT 73.8%; advanced-lesion sens 42.4% vs 23.8%; spec 86.6% vs FIT 94.9% — higher sensitivity but lower specificity = more false-positive colonoscopies (Imperiale NEJM 2014 PMID 24645800).
ct_colonography_q5yr
second line
imaging_screen
CT colonography q5yr • imaging • q5yr
triggers: colonoscopy_declined_or_incomplete
Structural alternative; extracolonic incidentalomas are a harm; positive/incomplete CTC → diagnostic colonoscopy (USPSTF 2021).
flexible_sigmoidoscopy_q5yr_or_q10yr_plus_fit
second line
endoscopy_screen
Flexible sigmoidoscopy q5yr (or q10yr + annual FIT) • procedure • q5-10yr
triggers: colonoscopy_unavailable_or_declined
UKFSS once-only (Atkin Lancet 2010 PMID 20430429): ITT CRC incidence HR 0.77 (0.70-0.84) / mortality HR 0.69 (0.59-0.82), distal CRC −50%, NNS 191 incidence / 489 death. PLCO (Schoen NEJM 2012 PMID 22612596): incidence RR 0.79 / mortality RR 0.74, distal-mortality RR 0.50, proximal mortality unaffected (distal-only test — Bayesian limitation).
lynch_aspirin_chemoprevention
comorbidity specific
chemoprevention
Daily aspirin (CAPP2 600 mg trial dose; clinical dose individualized) • PO • daily
triggers: confirmed_lynch_syndrome
CAPP2 (Burn Lancet 2020 PMID 32534647): in Lynch syndrome, daily aspirin reduced CRC HR 0.65 (95% CI 0.43-0.97) ITT at 10y, incidence-rate ratio 0.58. Adjunct to intensified colonoscopy, not a substitute. No hand-authored RxCUI — screening engine; clinical dose per specialist (RxNav validation deferred per dispatch).

outpatient playbook — drug actions (1)

1. daily aspirin (Lynch chemoprevention)
CAPP2 trial dose 600 mg; clinical dose individualized • PO • daily
trigger: Confirmed Lynch syndrome, shared decision (CAPP2 Burn Lancet 2020 PMID 32534647)
CRC HR 0.65 ITT in Lynch; adjunct to intensified colonoscopy — weigh GI-bleed risk; no hand-authored RxCUI (screening engine)

Auto-drafted A&P note

outpatient

Subjective

- Possible entry pathways: Routine preventive/wellness visit — CRC screening due age 45-75 (USPSTF 2021 Grade A 50-75 / B 45-49 PMID 34003218); Overdue or never-screened patient identified at any encounter — health-equity recall (USPSTF 2021); FDR with CRC, or known Lynch/FAP — earlier + more frequent surveillance (NCCN 2024; USMSTF 2017).

Objective

- No vitals, labs, or imaging entered for this encounter.

Assessment

**Colorectal cancer screening (adult)** (prev.colorectal-screening.v1).
Phenotype framing: Average-risk vs high-risk (Lynch/FAP/FDR-CRC/IBD) pathway, AND true-positive (advanced adenoma / CRC) vs false-positive (FIT cross-reactivity, NSAID/diet, non-advanced tubular adenoma overdiagnosis). The false-positive cascade (unnecessary colonoscopy bleeding/perforation) and overdiagnosis of non-advanced polyps are encoded as harm data, not prose. Screen-positive routes to diagnostic colonoscopy; screen-negative returns to interval (USPSTF 2021; NordICC harm PMID 36214590)
Scope: Confirm CRC screening scope: asymptomatic adult age 45-75 (76-85 individualized Grade C; discontinue >85), life expectancy ≥10 yr (below which lead-time + colonoscopy harm + non-advanced-adenoma overdiagnosis > benefit → STOP-screening). Excludes symptomatic workup (hematochezia/iron-def anemia/weight loss → diagnostic, gi.lgib.core.v1) and prior-CRC survivorship surveillance (USPSTF 2021 PMID 34003218)

No severity triggers fired against current inputs.

Plan

Regimen axis: **Colorectal — colonoscopy / FIT / FIT-DNA / CTC / flex-sig (USPSTF 2021 Grade A/B PMID 34003218; ACS 2018 PMID 29846947)**.
1. colonoscopy_q10yr Colonoscopy q10yr, age 45-75 average-risk procedure q10yr (endoscopy_screen, first line) — Adenoma sens ~95% (reference standard). NordICC (Bretthauer NEJM 2022 PMID 36214590): ITT 10-yr CRC risk 0.98% vs 1.20% (RR 0.82, 95% CI 0.70-0.93), NNT-invite 455, CRC-death RR 0.90 (95% CI 0.64-1.16, NS at 10y — ITT dilution, 42% screened). Harm: 15 major bleeds / ~11,843 screened, no perforations/deaths ≤30d. USPSTF 2021 Grade A 50-75 / B 45-49.
2. fit_annual FIT annually, age 45-75 lab annual (stool_screen, first line) — Pooled sens 0.79 (95% CI 0.69-0.86) / spec 0.94 (0.92-0.95), LR+ 13.10, LR− 0.23 — Lee Ann Intern Med 2014 PMID 24658694; cutoff-dependent (sens 0.89 at <20 µg/g). A positive FIT raises post-test probability enough to mandate diagnostic colonoscopy.
3. fit_dna_stool_test_q1_3yr Multitarget stool DNA (FIT-DNA / Cologuard) q1-3yr lab q1-3yr (stool_screen, second line) — CRC sens 92.3% vs FIT 73.8%; advanced-lesion sens 42.4% vs 23.8%; spec 86.6% vs FIT 94.9% — higher sensitivity but lower specificity = more false-positive colonoscopies (Imperiale NEJM 2014 PMID 24645800).
4. ct_colonography_q5yr CT colonography q5yr imaging q5yr (imaging_screen, second line) — Structural alternative; extracolonic incidentalomas are a harm; positive/incomplete CTC → diagnostic colonoscopy (USPSTF 2021).
5. flexible_sigmoidoscopy_q5yr_or_q10yr_plus_fit Flexible sigmoidoscopy q5yr (or q10yr + annual FIT) procedure q5-10yr (endoscopy_screen, second line) — UKFSS once-only (Atkin Lancet 2010 PMID 20430429): ITT CRC incidence HR 0.77 (0.70-0.84) / mortality HR 0.69 (0.59-0.82), distal CRC −50%, NNS 191 incidence / 489 death. PLCO (Schoen NEJM 2012 PMID 22612596): incidence RR 0.79 / mortality RR 0.74, distal-mortality RR 0.50, proximal mortality unaffected (distal-only test — Bayesian limitation).
6. lynch_aspirin_chemoprevention Daily aspirin (CAPP2 600 mg trial dose; clinical dose individualized) PO daily (chemoprevention, comorbidity specific) — CAPP2 (Burn Lancet 2020 PMID 32534647): in Lynch syndrome, daily aspirin reduced CRC HR 0.65 (95% CI 0.43-0.97) ITT at 10y, incidence-rate ratio 0.58. Adjunct to intensified colonoscopy, not a substitute. No hand-authored RxCUI — screening engine; clinical dose per specialist (RxNav validation deferred per dispatch).

Setting playbook (outpatient) — Set the pre-test prevalence prior (age + risk tier), order the age/risk-appropriate CRC screen via shared-decision modality menu, apply PPV reasoning to a positive non-colonoscopy test (→ diagnostic colonoscopy), assign the surveillance interval by polyp histology, route follow-up, document harms, schedule recall, and apply STOP-screening logic when harm exceeds benefit (USPSTF 2021 PMID 34003218; USMSTF 2017/2020)
7. daily aspirin (Lynch chemoprevention) CAPP2 trial dose 600 mg; clinical dose individualized PO daily — Confirmed Lynch syndrome, shared decision (CAPP2 Burn Lancet 2020 PMID 32534647) (CRC HR 0.65 ITT in Lynch; adjunct to intensified colonoscopy — weigh GI-bleed risk; no hand-authored RxCUI (screening engine))

Non-pharmacologic actions:
- Order CRC screen via shared-decision menu: colonoscopy q10y / FIT annual / FIT-DNA q1-3y / CTC q5y / flex-sig q5y or q10y+FIT (USPSTF 2021)
- Positive FIT/FIT-DNA/flex-sig → diagnostic colonoscopy (PPV crosses work-up threshold — Lee PMID 24658694; Imperiale PMID 24645800)
- Assign post-polypectomy surveillance interval by USMSTF 2020 histology strata (Gupta PMID 32044092)
- Lynch → colonoscopy q1-2y from 20-25 + genetics + cascade testing (NCCN 2024); FAP → annual sig/colonoscopy from 10-15 (NCCN 2024)
- FDR-CRC → start 40 or 10y before youngest dx, colonoscopy q5y (USMSTF 2017)
- IBD → surveillance colonoscopy from 8y post-pancolitis dx, q1-3y; route gi.crohns/gi.ulcerative-colitis for disease management (USMSTF)
- Refer to genetics if hereditary-syndrome criteria met (NCCN 2024)
- Patient education: FIT sens/spec, FIT-DNA lower specificity (more unnecessary colonoscopies), colonoscopy bleeding/perforation harm, non-advanced-adenoma overdiagnosis, value of stopping when harm dominates (USPSTF 2021)

AVOID / contraindication checks:
- No_routine_screening_lt_age_45_average_risk (USPSTF 2021 PMID 34003218; ACS 2018 — prior below testing threshold)
- Selective_screening_age_76_to_85_individualized_by_health_and_prior_screening (USPSTF 2021 Grade C)
- Stop_screening_after_age_85_or_life_expectancy_lt_10yr_harm_exceeds_benefit (USPSTF 2021 — deprescribing equivalent)
- Alarm_symptoms_hematochezia_irondef_weightloss_are_diagnostic_not_screening_exit_to_gi_lgib (ACG — test characteristic context changes)
- Special_pop:lynch_syndrome_colonoscopy_q1_to_2yr_starting_age_20_25_plus_aspirin_chemoprevention (NCCN 2024; CAPP2 PMID 32534647)
- Special_pop:FAP_annual_sigmoidoscopy_colonoscopy_from_age_10_15_then_colectomy_planning (NCCN 2024)
- Special_pop:FDR_CRC_start_age_40_or_10yr_before_youngest_dx_colonoscopy_q5yr (USMSTF 2017)
- Special_pop:IBD_surveillance_colonoscopy_8yr_after_pancolitis_dx_q1_3yr_not_average_risk_interval (USMSTF — route gi.crohns/gi.ulcerative colitis for management)
- Special_pop:pregnancy_defer_non_urgent_colonoscopy_and_ctc (radiation/sedation; resume postpartum)
- Special_pop:prior_crc_survivor_use_survivorship_surveillance_not_average_risk_screening (NCCN 2024)

Monitoring

Regimen monitoring:
- colonoscopy q10yr average risk (USPSTF 2021)
- annual FIT or fit dna q1 3yr or ctc q5yr or flexsig q5 10yr average risk (USPSTF 2021)
- positive noncolonoscopy test to diagnostic colonoscopy then USMSTF 2020 post polypectomy interval (Gupta PMID 32044092)
- post polypectomy histology strata: 1-2 tubular lt10mm→7-10yr; 3-4 adenomas→3-5yr; advanced or ge5 or villous or HGD or ge10mm→3yr; piecemeal ge20mm→6mo (USMSTF 2020)
- lynch colonoscopy q1 2yr; FAP annual; FDR CRC q5yr; IBD surveillance q1 3yr from 8yr post dx
- stop screening review age gt 85 or life expectancy lt 10yr (USPSTF 2021)

Setting (outpatient) monitoring:
- Colonoscopy q10y or FIT annual or FIT-DNA q1-3y or CTC q5y or flex-sig q5-10y average-risk (USPSTF 2021)
- Post-polypectomy surveillance per USMSTF 2020 histology strata (Gupta PMID 32044092 / GIE PMID 32044106)
- Lynch colonoscopy q1-2y; FAP annual; FDR-CRC q5y; IBD surveillance q1-3y from 8y post-dx
- Positive non-colonoscopy test interrupts interval → diagnostic colonoscopy then USMSTF interval

Follow-up plan: STOP-screening logic (the deprescribing-equivalent): discontinue when life expectancy <10 yr or age >85; age 76-85 = individualized decision weighing health, prior-screening history, and patient values (USPSTF 2021 Grade C). Patient education on FIT false-positive rate, FIT-DNA lower specificity (more unnecessary colonoscopies), colonoscopy bleeding/perforation harm, non-advanced-adenoma overdiagnosis, and the value of NOT screening when harm dominates (USPSTF 2021)
- Close-out criterion: Stop-screening decision OR continued-interval education delivered and documented

Monitoring phase: Interval + recall: colonoscopy q10y average-risk; FIT annual; FIT-DNA q1-3y; CTC q5y; flex-sig q5y (or q10y + annual FIT) (USPSTF 2021 PMID 34003218). Post-polypectomy surveillance per USMSTF 2020 histology strata (Gupta PMID 32044092 / GIE PMID 32044106). Lynch colonoscopy q1-2y; FAP annual; FDR-CRC q5y; IBD surveillance q1-3y from 8 yr post-dx. A positive non-colonoscopy test interrupts the interval → diagnostic colonoscopy then USMSTF interval

Disposition

Current setting: outpatient — Set the pre-test prevalence prior (age + risk tier), order the age/risk-appropriate CRC screen via shared-decision modality menu, apply PPV reasoning to a positive non-colonoscopy test (→ diagnostic colonoscopy), assign the surveillance interval by polyp histology, route follow-up, document harms, schedule recall, and apply STOP-screening logic when harm exceeds benefit (USPSTF 2021 PMID 34003218; USMSTF 2017/2020)

Disposition criteria:
- Continue per interval if results negative and still age/risk-eligible (USPSTF 2021)
- Refer to GI/diagnostic pathway for positive screen / advanced histology (USPSTF 2021; USMSTF 2020)
- STOP screening when life expectancy <10 yr or age >85; 76-85 individualized — deprescribing-equivalent (USPSTF 2021)

Escalation triggers (move to higher acuity):
- Advanced adenoma or CRC on colonoscopy → GI/oncology (no CRC-staging engine in repo — route narratively; USMSTF 2020)
- Alarm hematochezia / symptomatic occult bleed → gi.lgib.core.v1 (NOT screening)
- Confirmed Lynch/FAP → NCCN high-risk protocol + cascade testing (NCCN 2024)
- IBD dysplasia on surveillance → gi.crohns.core.v1 / gi.ulcerative-colitis.core.v1 for management (USMSTF)

Earlier-Return Triggers

Return-precaution thresholds (watch for):
- [SEVERE] Positive FIT (LR+ ~13.10 — Lee PMID 24658694), positive FIT-DNA (CRC sens 92.3% — Imperiale PMID 24645800), positive flexible sigmoidoscopy, or incomplete/positive CTC — post-test probability now high enough that the harm of NOT working up exceeds the harm of the diagnostic colonoscopy
- [SEVERE] Confirmed Lynch (MLH1/MSH2/MSH6/PMS2 — CRC lifetime ~50-80%) or FAP (APC, near-100% CRC) — very high prior requiring earlier + far more frequent colonoscopy; Lynch adds aspirin chemoprevention (CAPP2 CRC HR 0.65 — PMID 32534647)
- [SEVERE] Hematochezia, iron-deficiency anemia, unexplained weight loss, or obstructive change in bowel habit — the patient is symptomatic; this is NOT screening (the pre-test prevalence and test characteristics no longer apply) → exit to diagnostic colonoscopy / gi.lgib.core.v1

Citations

- USPSTF 2021 colorectal cancer screening recommendation statement (Grade A 50-75 / B 45-49 / C 76-85) + ACS 2018 (start 45) + USMSTF 2020 post-polypectomy surveillance + USMSTF 2017 high-risk + NCCN 2024 Lynch/FAP [PMID:34003218](https://pubmed.ncbi.nlm.nih.gov/34003218/)
- Cited evidence (PMID 29846947) [PMID:29846947](https://pubmed.ncbi.nlm.nih.gov/29846947/)
- Cited evidence (PMID 36214590) [PMID:36214590](https://pubmed.ncbi.nlm.nih.gov/36214590/)
- Cited evidence (PMID 20430429) [PMID:20430429](https://pubmed.ncbi.nlm.nih.gov/20430429/)
- Cited evidence (PMID 22612596) [PMID:22612596](https://pubmed.ncbi.nlm.nih.gov/22612596/)

Last reconciled with current guidelines: 2026-05-16.

References

USPSTF 2021 colorectal cancer screening recommendation statement (Grade A 50-75 / B 45-49 / C 76-85) + ACS 2018 (start 45) + USMSTF 2020 post-polypectomy surveillance + USMSTF 2017 high-risk + NCCN 2024 Lynch/FAP — PMID:34003218
Cited evidence (PMID 29846947) — PMID:29846947
Cited evidence (PMID 36214590) — PMID:36214590
Cited evidence (PMID 20430429) — PMID:20430429
Cited evidence (PMID 22612596) — PMID:22612596