Surveillance colonoscopy in patients with colorectal cancer: how often should we be doing it?
BACKGROUND
The optimum protocol for colonoscopic surveillance following curative resection for colorectal cancer has not been established. The aim was to assess the incidence of recurrence and metachronous tumours in our less intensive colonoscopic surveillance programme and compare our results with those reported from intensive surveillance programmes.


METHODS
Colonoscopic records of patients who had surveillance colonoscopy following curative resection from April 1998 to March 2003 for cancer were available from the endoscopy department computer database. The variables studied included the tumour site, Duke's stage, number of recurrences, number of metachronous tumours, size and number of polyps and their biopsy results.


RESULTS
There were a total of 105 patients. Two patients were diagnosed with metachronous tumours and three with recurrence. Adenomatous polyps were identified in 24 patients of which nine had multiple/advanced adenomas (equal to or more than 1cm adenomatous polyps, or with severe dysplasia).


CONCLUSIONS
The risk of development of colonic pathology following curative resection for colorectal cancer is low. More intensive follow-up should be reserved for patients with additional risk of developing further cancers.
Mathew
J
J
Trafford General Hospital, Manchester, UK. mathewjohn9@aol.com
Saklani
A K
AK
Borghol
M
M
D000236:Adenoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods; D003113:Colonoscopy / Q000592:standards / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000453:epidemiology; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom