Criteria used for each trigger algorithm
| Colorectal cancer triggers | ||||
|---|---|---|---|---|
| Prostate cancer trigger | Faecal occult blood test (FOBT) | Iron deficiency anaemia (IDA) | Haematochezia | |
| Demographic criteria | Age 40–70 years Alive* 90 days after the PSA result | Age 40–75 years Alive* 60 days after positive FOBT | Age 40–75 years Alive 60 days after Haemoglobin result* | Age 40–75 years Alive* 60 days after haematochezia diagnosis |
| Red flag criteria | PSA result of 4.1–15 ng/mL No PSA ≥4.1 ng/mL in prior 2 years | Positive FOBT test | Lab results consistent with IDA: ▸ Haemoglobin≤11 g/dL, ▸ Mean corpuscular volume≤81 fL, and ▸ No ferritin≥100 ng/mL in prior 12 months | New diagnosis of haematochezia |
| Clinical exclusion criteria | Prior history of prostate cancer Prior prostate biopsy within prior 2 years Prostatitis diagnosis within 30 days prior to or 90 days after red flag criteria met Terminal illness diagnosis Hospice/palliative care enrolment | Colonoscopy within 5 years prior to red flag criteria met Prior history of colorectal cancer Prior total colectomy Terminal illness diagnosis Hospice/palliative care enrollment Upper GI bleed within 1 year before or 60 days after red flag criteria met | Colonoscopy within 3 years prior to red flag criteria met Prior thalassaemia diagnosis (ICD-9 code) Hospitalisation within 14 days prior to red flag criteria met Surgery within 14 days prior to red flag criteria met Menorrhagia diagnosis within 5 years prior or 60 days after red flag criteria met Other cause of bleeding within 1 year prior or 60 days after red flag criteria met Pregnant within 1 year prior to or 60 days after red flag criteria met Prior history of colorectal cancer Prior total colectomy Terminal illness diagnosis Hospice/palliative care enrollment Upper GI bleed within 1 year before or 60 days after red flag criteria met | Colonoscopy within 3 years prior to red flag criteria met Prior history of colorectal cancer Prior total colectomy Terminal illness diagnosis Hospice/palliative care enrollment Upper GI bleed within 1 year before or 60 days after red flag criteria met |
| Expected follow-up criteria | Any of the following within 90 days after red flag criteria met: ▸ Repeat PSA performed ▸ Urology consult requested or completed ▸ Prostate biopsy performed | Colonoscopy performed within 60 days after red flag criteria met | Colonoscopy performed within 60 days after red flag criteria met | Colonoscopy performed within 60 days after red flag criteria met |
*As identified from social security number-based death index.
FOBT, faecal occult blood test; GI, gastrointestinal; IDA, iron deficiency anaemia; PSA, prostate specific antigen.