Created: four seed files, 18 canonical pages, overview with 25 PMIDs, and 7 seed questions.
Searches run (live PubMed E-utilities esearch/esummary): global burden and young-onset epidemiology; adenoma–carcinoma/serrated pathways and CMS; Lynch/FAP; USPSTF, NordICC and FIT screening; MOSAIC; DYNAMIC ctDNA; RAPIDO, PRODIGE 23, STELLAR and OPRA; TRIBE2, cetuximab/bevacizumab, BEACON and KEYNOTE-177; metastatic review.
Verification: every cited PMID was returned live by PubMed. One recalled historical rectal-surgery identifier returned no usable metadata and was excluded.
Next: full build queued per CONDITIONS-ROADMAP.md.
Scope completed: wrote all 18 planned wiki pages. Each page is 182–223 lines and carries 25–49 verified PubMed citations, except the clinical-trials landscape, which combines 19 verified PubMed papers with 31 live-verified ClinicalTrials.gov records.
PubMed retrieval: ran 131 live E-utilities searches across epidemiology, carcinogenesis, pathology, molecular biology, hereditary syndromes, screening, localized and metastatic treatment, metastasis-directed therapy, survivorship, safety, guidelines, biomarkers and patient experience. The combined live cache contains 613 retrievable PubMed records; 301 unique papers are cited in the condition and indexed in literature/BIBLIOGRAPHY.md.
ClinicalTrials.gov retrieval: ran 15 live API-v2 searches covering adjuvant ctDNA, rectal organ preservation, neoadjuvant immunotherapy, metastatic targeted therapy, KRAS/BRAF/HER2, cellular and vaccine approaches, liver metastasis and young-onset disease. The union cache contained 445 NCT records; the landscape page selected 31 records with status and design context.
Literature layer: built the master bibliography; six landmark-paper notes; a 28-document guideline registry with supersession chains and disagreement matrix; a 164-line statistics sourcebook; and a four-file patient-voice layer.
Patient voice: fetched ten organizations' own public sites across North America, Europe, Australasia, Malaysia and South Africa; documented visible services and limitations; and synthesized 12 aggregate themes under a minimum two-independent-source rule. No private groups, named private individuals or individual testimonials were used.
Research frontier: replaced the seed list with 30 stable-ID questions in two tiers and a 12-row “Dots not yet connected” table.
Indexing: updated INDEX.md with reading paths, canonical links, page statuses and literature-layer counts; changed the condition roadmap state from seeded to built.
Citation integrity: every PMID written during this build was checked against the session's live PubMed cache; every NCT identifier was checked against the session's live ClinicalTrials.gov cache. Recalled identifiers that were not present in those caches were rejected or replaced with the live-verified record.
Deliberate limits: no formal search-protocol registration, dual-review screening or risk-of-bias adjudication was attempted, so this is a deep evidence map rather than a systematic review. Patient-experience coverage remains weighted toward English-language, high-income-country sources. Living commercial guidelines were represented by retrievable peer-reviewed guideline records and the registry flags version volatility.
Audit state: full build completed, but no separate audit was performed in this session. All wiki pages therefore remain status: draft, as required by the build playbook.
Scope checked: audited all 18 canonical wiki pages and all 13 Markdown artifacts in literature/, plus OPEN-QUESTIONS.md, INDEX.md and the condition-level bibliography relationships. All pages remained within the 150–400-line target.
PubMed verification: re-fetched all 301 pre-existing unique PMIDs with live PubMed E-utilities and fetched three newly relevant records exposed by refreshed gap searches, for 304/304 resolving records. Reconciled 983 non-bibliography claim→PMID links across 728 claim lines and 1,773 total PMID occurrences when page references, bibliography entries and this audit log are included. Author, title, journal and year matched the live records; ePub/print offsets were tolerated.
ClinicalTrials.gov verification: re-fetched all 31 unique cited NCT records (36 occurrences) through API v2. Every identifier resolved and every displayed recruitment status matched the 2026-08-30 live record; no status correction was required.
Non-journal verification: fetched all 15 unique external URLs cited in the condition; 15/15 returned HTTP 200 after redirects. Updated organization and guideline access dates to 2026-08-30.
Errors found and fixed: 11 substantive issue clusters affecting 37 claim or table locations. Corrected GBD 2019 CRC burden from 1.2 million cases/572,000 deaths to 2.17 million (95% UI 2.00–2.34)/1.09 million (95% UI 1.00–1.15); removed unsupported rounded GLOBOCAN percentage increases; corrected NordICC usual-care incidence from 1.22% to 1.20%; corrected the Pieniowski cohort from 41% major/35% no LARS to 53.1%/22.6%; aligned RAPIDO recurrence reporting to 44/431 (10%) versus 26/428 (6%); removed MOUNTAINEER duration/PFS numbers absent from the cited PubMed abstract while retaining response 38.1% (95% CI 27.7–49.3); removed an unsupported 30–60% lung-metastasis survival range; replaced unstated transplant-score thresholds with abstract-reported strata and estimates; and softened overbroad CMS utility language.
Refreshed evidence-gap searches: re-ran targeted PubMed searches for ablation versus resection, CMS-guided therapy, bevacizumab expression selectors, blood-screening mortality, screening below age 50, field-effect surveillance, pMMR/MSS immunotherapy conversion, post-metastasectomy ctDNA and cascade-testing interventions. The former “no randomized ablation comparison” statement was stale: a 2026 synthesis includes one randomized trial (PMID 42463528). The former “no comparative direct-contact evidence” statement was also stale: a 2025 Swedish randomized trial found 71% versus 67% counselling uptake, adjusted OR 1.24 (95% CI 0.79–1.95; PMID 40745491). PanaMa retrospective CMS analysis within a randomized trial (PMID 37018649) was added while preserving the dated gap in prospective CMS-directed treatment assignment.
Bibliography and closure checks: bibliography now contains 304 unique PMIDs, exactly covering the condition's PMID set with no orphan or missing entry. Every wiki body PMID appears in that page's References section and every page reference is used in the body. All 18 page link targets are canonical and present.
Remaining flags: zero unresolved verification markers, zero unresolved PMID/NCT identifiers, zero unresolved citation-reference mismatches and zero unresolved substantive audit issues. Methodological limitations remain: this is not a registered systematic review, no dual-review risk-of-bias adjudication was performed, and patient-voice coverage remains English-language/high-income-country weighted.
Status changes: promoted all 18 wiki pages from draft to curated, updated INDEX.md to audited, and changed the colorectal adenocarcinoma row in CONDITIONS-ROADMAP.md from built to audited.