How do gastroenterologists follow patients with colorectal cancer after curative surgical resection? A three-year population-based study.
OBJECTIVE
To assess the contribution of gastroenterologists (GEs) to the surveillance of colorectal cancer after curative surgery.


METHODS
This registry-based study included 407 patients residing in two French administrative areas diagnosed with newly diagnosed colorectal cancer in 1998 and free of disease six months after curative surgery. All surveillance examinations performed either in the three years after surgery or until death or recurrence were collected retrospectively.


RESULTS
One hundred nine patients (27%) had a regular clinical check-up with a GE at least once a year. Factors independently associated with GE follow-up were young age (P=0.004), use of adjuvant chemotherapy (P=0.013), and surgeon follow-up (P=0.068). GEs ordered 84% of colonoscopies, 44% of abdominal ultrasound examinations and 52% of abdominal CT scans. They detected 35% of recurrences. A significant proportion of patients (20%) had no regular follow-up, irrespective of the physicians involved.


CONCLUSIONS
GEs play a modest role in the routine follow-up of patients with colorectal cancer, but are largely involved in ordering surveillance tests. They might play an important role in the surveillance of patients who presently have poor access to health care.
Coriat
Romain
R
Inserm, U866, Dijon, Université de Bourgogne, CHRU Dijon, Dijon.
Mahboubi
Amel
A
Lejeune
Catherine
C
Bouvier
Anne-Marie
AM
Bedenne
Laurent
L
Bonithon-Kopp
Claire
C
D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000628:therapy*; D003266:Continuity of Patient Care; D005260:Female; D005602:France / Q000453:epidemiology; D005762:Gastroenterology; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011860:Radiography, Abdominal / Q000706:statistics & numerical data; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012189:Retrospective Studies; D014463:Ultrasonography