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 | | |
More CRICO Guidelines or Algorithms
CRICO decision support tools.
General Informed Consent Guidelines
Guideline
A document to assist institutions in reviewing policies, procedures and forms relative to obtaining and documenting informed consent.
Challenge: Take the OB Clinical Guidelines Test
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Take this test and see if you already follow these best practices from the Obstetrical Services of the CRICO-insured Institutions.
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.
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)