Cancer survivor ≥5 years post-completion of curative-intent oncology treatment that inclu...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-UROTHELIAL`
Sources	`SRC-COG` `SRC-NCCN-BCELL-2025` `SRC-NCCN-BLADDER-2025` `SRC-NCCN-COLON-2025`

Red Flag Origin

Definition	Cancer survivor ≥5 years post-completion of curative-intent oncology treatment that included pediatric pelvic radiotherapy. Most commonly: Wilms tumor flank/pelvic RT, Ewing sarcoma pelvic primary, pediatric rhabdomyosarcoma (genitourinary, paratesticular, bladder/prostate primary), Hodgkin lymphoma pelvic field, neuroblastoma abdominopelvic RT, testicular GCT pelvic adjuvant (less common in pediatric era). Three principal second-primary surveillance domains: (1) bladder cancer — radiation cystitis with chronic inflammation drives urothelial carcinoma decades later; cumulative risk 2-4% at 25-30y post-pediatric pelvic RT; (2) colorectal cancer — radiation field exposure to rectum + distal colon; standardized incidence ratio (SIR) 3-5x population baseline, cumulative 5-10% at 30y depending on dose + field; (3) other pelvic-field secondary cancers (uterine, ovarian if ovaries in field, ce...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "survivor_pediatric_pelvic_rt_late_effect",
      "value": true
    },
    {
      "finding": "survivor_5y_post_pediatric_pelvic_rt",
      "value": true
    },
    {
      "finding": "survivor_pediatric_abdominopelvic_rt_late_effect",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Cancer-survivor late-effects RedFlag for prior pediatric pelvic radiotherapy ≥5y ago. Three surveillance domains: bladder cancer (urothelial — primary anchor), CRC (earlier screening at 45 or 10y post-RT), other pelvic-field secondaries. Annual UA + cytology + CRC screening earlier per COG-LTFU + CCSS. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications

IND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-OBSERVATION - IND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-OBSERVATION
IND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-SURVEILLANCE - IND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-SURVEILLANCE