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Maladie inflammatoire inflammable de longue date (EIB) avec implication...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-IBD-CRC-PREVENTION
TypeSignal d’alerte
Étatreviewed 2026-05-18 | pending_clinical_signoff
MaladiesDIS-CRC
SourcesSRC-ESMO-COLON-2024 SRC-ESMO-CRC-2024 SRC-NCCN-COLON-2025

Origine du drapeau rouge

DéfinitionLong-standing inflammatory bowel disease (IBD) with colonic involvement — either ulcerative colitis (UC) with diagnosis ≥8 years, or Crohn's colitis (involvement of ≥1/3 of colon) with diagnosis ≥8 years, or IBD with concomitant primary sclerosing cholangitis (PSC) regardless of duration (PSC-IBD is the highest-risk IBD subgroup for colorectal cancer — cumulative CRC risk ~15-30% at 30 years from PSC diagnosis). No current colorectal cancer diagnosis. Chronic colonic inflammation drives colitis-associated dysplasia and CRC via an inflammation-dysplasia-carcinoma sequence distinct from sporadic CRC (often arises from flat dysplasia, multifocal, harder to detect by conventional white-light colonoscopy). Surveillance colonoscopy with chromoendoscopy or high-definition white-light reduces CRC mortality in this population. Prevention-persona RedFlag (§20 ratification 2026-05-18, v0.3 chronic...
Direction cliniqueenquêter
Catégorieautres

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "inflammatory_bowel_disease_uc_diagnosis_ge_8y",
      "value": true
    },
    {
      "finding": "inflammatory_bowel_disease_crohn_colitis_ge_8y",
      "value": true
    },
    {
      "finding": "inflammatory_bowel_disease_with_primary_sclerosing_cholangitis",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

v0.3 chronic-condition prevention pilot — IBD-associated CRC. Prevention-persona RedFlag (CHARTER §3 amended 2026-05-18 Path A, HCP-mediated). Fires when patient profile shows long-standing IBD with colonic involvement AND no confirmed CRC. Engine routes to PreventionPlan with 2 tracks: surveillance colonoscopy with chromoendoscopy q1-2y per AGA/ECCO/NCCN (IND-IBD-CRC-PREVENTION-CHROMOENDOSCOPY) as standard; routine q3-5y colonoscopy (IND-IBD-CRC-PREVENTION-OBSERVATION) as alternative — clinically below standard-of-care but included per §15.2 C4 and CHARTER §11 patient-autonomy framing. Evidence base: - **AGA Clinical Practice Update on Surveillance and Management of Dysplasia in IBD (2021):** Chromoendoscopy with targeted biopsies preferred over white-light random biopsies. q1-3y surveillance from 8-10y after IBD diagnosis (extension of colitis matters more than duration), or from PSC diagnosis in PSC-IBD. - **ECCO Guideline on IBD-associated CRC (2024):** Aligns with AGA; additionally recommends high-definition white-light + virtual chromoendoscopy (NBI, BLI) as alternative to dye-spray when chromoendoscopy not available. - **CRC risk in UC (Eaden meta-analysis JAMA 2001 + updat...

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Indication

Signal d’alerte