Severe obesity — BMI ≥40 kg/m² (WHO class III obesity), distinct from the broader RF-LIFE...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-CHRONIC-SEVERE-OBESITY-BMI40-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-20 \| очікує клінічного підпису
Хвороби	`DIS-BREAST` `DIS-CRC` `DIS-ENDOMETRIAL`
Джерела	`SRC-NCCN-BCELL-2025` `SRC-WCRF-AICR-CUP-2018`

Походження тривожної ознаки

Визначення	Тяжке ожиріння — BMI ≥40 кг/м² (WHO class III ожиріння), відмінне від ширшого RF-LIFESTYLE-OBESITY-CANCER-PREVENTION (який покриває BMI ≥30 class I-III). Тяжке ожиріння carries multiplicative cancer-risk effects (linear-then-accelerating dose-response per WCRF/AICR + IARC) особливо для hormonally-driven cancers: endometrial (RR ~7-10), esophageal adenocarcinoma (RR ~4-5), post-menopausal breast (RR ~1.5-2), colorectal (RR ~1.5-2), RCC (RR ~2), HCC (RR ~2-4 via NAFLD/MASH), PDAC (RR ~2). Severe obesity also defines bariatric- surgery-candidate cohort (BMI ≥40 alone, або BMI ≥35 з obesity- related comorbidity), і bariatric surgery has documented cancer- incidence reduction (~30% relative для hormonally-driven cancers). Categorized як chronic_condition тому що severe obesity carries metabolic + endocrine pathophysiology distinct від sedentary-only lifestyle elevation. Prevention-persona Re...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "bmi_ge_40_severe_obesity_bariatric_candidate",
      "value": true
    },
    {
      "finding": "severe_obesity_class_3_diagnosis",
      "value": "positive"
    },
    {
      "finding": "bmi_ge_35_with_obesity_comorbidity_bariatric_candidate",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

v0.3 wave-N niche pathway — severe obesity (BMI ≥40) prevention. Fires on documented BMI ≥40 kg/m² OR BMI ≥35 with documented obesity-related comorbidity (T2DM, sleep apnea, NAFLD, hypertension, hyperlipidemia) — the bariatric-surgery-candidate cohort definition. Distinct finding name from the broader-obesity RF (which fires on bmi_ge_40 alone) so that the engine can present BOTH tracks when applicable but they are not redundant (severe obesity opens bariatric-surgery pathway + intensified screening discussion that the general obesity RF does not specifically cover). Engine routes to PreventionPlan recommending: (a) IND-SEVERE-OBESITY-CANCER-PREVENTION-INTENSIFIED (standard) — structured weight-loss intervention with multidisciplinary bariatric program (medical weight loss including GLP-1 agonists / semaglutide / tirzepatide, behavioral, surgical referral when BMI ≥40 alone or BMI ≥35 with comorbidity); intensified cancer screening per affected-organ guideline (mammography from age 40, colonoscopy from age 45 with no upward-deferral, endometrial-symptom awareness with low- threshold ultrasound for postmenopausal bleeding); NAFLD screening + management; comorbidity management. (b)...

Де використовується

Indications

IND-SEVERE-OBESITY-CANCER-PREVENTION-INTENSIFIED - IND-SEVERE-OBESITY-CANCER-PREVENTION-INTENSIFIED
IND-SEVERE-OBESITY-CANCER-PREVENTION-OBSERVATION - IND-SEVERE-OBESITY-CANCER-PREVENTION-OBSERVATION