title: Optimal post-treatment surveillance in cancer survivors: is more really better?
abstract: A substantial rise in the number of cancer survivors has led to management questions regarding effective post-treatment surveillance strategies. Although a number of professional societies have proposed surveillance guidelines, clinical practice varies; the general trend is toward more intensive strategies. The evidence supporting intensive surveillance is relatively lacking, with most studies showing that more intense surveillance regimens have minimal, if any, impact on outcomes in terms of survival, quality of life, or overall cost-effectiveness. This has been demonstrated in breast cancer, and data supporting a similar conclusion may be evolving in colorectal cancer, where large prospective studies call into question the utility of intensive surveillance; in prostate cancer, retrospective data suggest a similar trend. In this review, we discuss the established guidelines and current evidence regarding post-treatment surveillance, and we propose general management strategies in prostate, colorectal, and breast cancers.
authors.forename: Megha
authors.initials: M
authors.lastname: Shah
authors.forename: Crystal S
authors.initials: CS
authors.lastname: Denlinger
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D019317:Evidence-Based Medicine; D005260:Female; D017408:Guidelines as Topic; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000191:economics / Q000517:prevention & control*; D011159:Population Surveillance / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D011788:Quality of Life; D017741:Survivors; D014481:United States