title: Post-treatment surveillance in a large cohort of patients with colon cancer.
abstract: OBJECTIVE
  To determine how patients complied with different components of guideline-recommended post-treatment surveillance in a large nationwide population-based cohort of patients with colon cancer.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  We used the linked Surveillance, Epidemiology, and End Results-Medicare database to identify patients 66 years or older diagnosed as having stage I to stage III colon adenocarcinoma between January 2000 and June 2002 with a follow-up duration of at least 3.5 years. After tumor resection, patients who completed at least 2 office visits per year for 3 years, at least 2 carcinoembryonic antigen tests per year (in the first and second years of follow-up), and at least 1 colonoscopy within 3 years were defined as meeting the recommended post-treatment care.
  
  
  RESULTS
  We identified 7348 patients, with a median follow-up duration of 59 months. Adherence to post-treatment surveillance was 83.9% for office visits, 29.4% for carcinoembryonic antigen tests, and 74.3% for colonoscopy. Younger age at diagnosis, white race/ethnicity, married status, advanced tumor stage, fewer comorbidities, and chemotherapy use were significantly associated with guideline adherence.
  
  
  CONCLUSIONS
  Adherence to colon cancer posttreatment surveillance was low, although proportions of patients complying with office visits and colonoscopy were reasonably high. Underlying reasons for noncompliance, which varied by type of service, may need further investigation.
authors: Division of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, TX 77030, USA.
authors: Chung-Yuan
authors: CY
authors: Hu
authors: George L
authors: GL
authors: Delclos
authors: Wenyaw
authors: W
authors: Chan
authors: Xianglin L
authors: XL
authors: Du
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D003110:Colonic Neoplasms / Q000145:classification / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D009819:Office Visits / Q000706:statistics & numerical data; D010349:Patient Compliance; D011159:Population Surveillance; D012189:Retrospective Studies; D018426:SEER Program; D017741:Survivors / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D002272:Carcinoembryonic Antigen