Table 1.

Red Flag, Clinical Exclusion, and Expected Follow-Up Action Criteria by Cancer Type

Cancer	Red Flag Criteria	Clinical Exclusion Criteria	Expected Diagnostic Evaluation
Lung cancer	Any of the following flagged by radiologist as suspicious for malignancy: chest radiograph or chest CT scan	Age < 30 years Prior history of lung cancer Terminal illness diagnosis Hospice/palliative care enrollment Prior tuberculosis diagnosis Pulmonary evaluation within last 6 months	Any of the following within 30 days after red flag criteria: • Pulmonary referral completed • Lung procedure (biopsy, bronchoscopy, thoracic surgery) • Repeat x-ray or CT scan
Colon cancer	Positive FOBT, or New hematochezia diagnosis, or Laboratory results consistent with IDA: • Hemoglobin ≤ 11 g/dL • Mean corpuscular volume ≤ 81 fL • No ferritin ≥ 100 ng/mL in prior 12 months	Age < 40 or > 75 Colonoscopy within 5 years (for positive FOBT) or 3 years (for hematochezia or IDA) prior to high-risk 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 Additional IDA-specific criteria include the following: • Prior thalassemia diagnosis • Hospitalization within 14 days before red flag criteria met • Surgery within 14 days before high-risk criteria met • Menorrhagia diagnosis within 5 years before or 60 days after high-risk criteria met • Other cause of bleeding within 1 year before or 60 days after high-risk criteria met • Pregnant within 1 year before or 60 days after high-risk criteria met	Colonoscopy performed within 60 days after red flag criteria
Prostate cancer	PSA result of 4.1-15 ng/mL	Age < 40 or > 70 years Prior history of prostate cancer Prior prostate biopsy within prior 2 years Prostatitis diagnosis within 30 days before or 90 days after red flag criteria met Terminal illness diagnosis Hospice/palliative care enrollment	Any of the following within 90 days after red flag criteria: • Repeat PSA performed • Urology referral requested or completed • Prostate biopsy performed

Abbreviations: CT, computed tomography; FOBT, fecal occult blood test; IDA, iron deficiency anemia; PSA, prostate-specific antigen.