Surveillance approaches among colorectal cancer survivors after curative-intent.
Intensive surveillance among colorectal cancer patients receiving curative-intent, particularly during the first 2 to 3 years of follow-up, has a beneficial impact upon all-cause survival at five years. Intensive surveillance appears to be associated with the early detection of recurrences, and more often accompanied by a clinical presentation enabling surgical resection. The optimal combination and frequency of surveillance tests is unknown. Imaging of the chest and abdomen have increasingly been recommended by professional organizations, in addition to CEA levels, in order to detect resectable recurrences. Metachronous cancers are relatively uncommon, nonetheless, surveillance colonoscopy is typically recommended. Cau-tion is warranted in further advancing the intensity of surveillance, as increasingly aggressive surveillance programs risk increased detection of pseudodisease. Different types of information will enhance our understanding of the impact of follow-up programs, including data regarding quality of life, cost, and patient preferences.
Haggstrom
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VA Health Services Research & Development (HSR&D) Center on Implementing Evidence-based Practice (CIEBP), Roudebush VAMC, Indianapolis, IN, USA. dahaggst@iupui.edu
Imperiale
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D000367:Age Factors; D000941:Antigens; D002272:Carcinoembryonic Antigen / Q000097:blood; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D017741:Survivors; D013997:Time Factors
D000941:Antigens; D002272:Carcinoembryonic Antigen