Guideline
Decision Support Tool for Patients at High Risk for Colorectal Cancer
For patients assessed to be at a high risk for contracting colorectal cancer, this chart outlines appropriate screening and follow-up sequences.
Hereditary Gastrointestinal Polyposis and Nonpolyposis Syndromes
| Condition | Genes (Inheritance) | Key Clinical Features |
| Polyposis syndrome | ||
| Familial adenomatous polyposis (FAP) | APC (AD) | 100s–1,000s of colonic adenomatous polyps Duodenal/periampullary adenomas Onset in teenage years Prophylactic proctocolectomy is standard |
| Attenuated FAP | PC (AD) | <100 colonic adenomas, onset in adulthood |
| MYH-associated polyposis | MUTYH (AR) | Wide range in number of colon adenomas (few–1,000s) |
| Polymerase proofreading-associated polyposis | POLD1, POLE (AD) | 5–100 colon adenomas; Increased risk of endometrial cancer |
| Peutz-Jeghers Syndrome | STK11 (AD) | Peutz-Jeghers type hamartomatous polyps Perioral macular pigmentation High risk of colon, gastric, pancreatic, breast, and gynecologic cancers |
| Cowden Syndrome | PTEN (AD) | Multiple hamartomatous polyps High risk of thyroid cancer, breast cancer |
| Bannayan-Riley-Ruvalcaba | PTEN (AD) | Multiple hamartomatous polyps Macrocephaly Developmental delay |
| Juvenile polyposis | BMPR1A, SMAD4 (AD) | Multiple juvenile polyps Increased risk of colon cancer Hereditary hemorrhagic telangiectasia phenotype in some SMAD4 families |
| Serrated polyposis | Unknown | Multiple sessile serrated adenomas (at least five serrated polyps proximal to sigmoid colon, two of which are >1cm in size) |
| Nonpolyposis syndrome | ||
| Lynch | MLH1, MSH2, MSH6, PMS2, EPCAM (AD) | High risk of colon and endometrial cancer Absence of multiple polyps Most common hereditary colon cancer syndrome |
| AD autosomal dominant AR autosomal recessive | ||
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CME credit opportunity: Colorectal Cancer Decision Support Test
More CRICO Guidelines or Algorithms
CRICO decision support tools.
Challenge: Take the OB Clinical Guidelines Test
Guideline
Take this test and see if you already follow these best practices from the Obstetrical Services of the CRICO-insured Institutions.
Obstetrics Guidelines Listing
Guideline
Easily navigate this web-based version of the OB guidelines 1-35 and the sample form appendices A-H. The OB Guidelines PDF is also available on this page if you want to read or print it in booklet form. (2022 version available)
OB Guideline 15: Assessment and Monitoring in Labor and Delivery
Guideline
During prenatal care, the clinician and patient will discuss common events and procedures in labor, including methods of assessing fetal well-being.
Patient Safety Guidance for Perioperative Fire Safety
Guideline
The AMC PSO convened the Perioperative Fire Safety Task Force to consider the question of why fires continue to occur in operating rooms, and what to do about it.