title: Practice Guideline for the Surveillance of Patients After Curative Treatment of Colon and Rectal Cancer.
abstract: Current evidence suggests improved rates of curative secondary treatment following identification of recurrence among patients who participate in a surveillance program after initial curative resection of colon or rectal cancer. The newer data show that surveillance CEA, chest and liver imaging,and colonoscopy can also improve survival through early diagnosis of recurrence; thus, these modalities are now included in the current guideline. Although the optimum strategy of surveillance for office visits, CEA, chest and liver imaging, and colonoscopy is not yet defined, routine surveillance does improve the detection of recurrence that can be resected with curative intent. Recommended surveillance schedules are shown in Table 4. However, the factors to be considered when recommending surveillance include underlying risk for recurrence, patient comorbidity, and the ability to tolerate major surgery to resect recurrent disease or palliative chemotherapy, performance status, physiologic age, preference, and compliance. The success of surveillance for early detection of curable recurrence will depend on patient and provider involvement to adhere to the surveillance schedule and avoid unnecessary examination. It should be noted that, after curative resection of colorectal cancer, patients are still at risk for other common malignancies(lung, breast, cervix, prostate) for which standard screening recommendations should be observed and measures to maintain general health (risk reduction for cardiovascular disease, eg, cessation of smoking, control of blood pressure and diabetes mellitus, balanced diet, regular exercise and sleep, and flu vaccines) should be recommended.
authors.affiliation: Prepared by The Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
authors.forename: George J
authors.initials: GJ
authors.lastname: Chang
authors.forename: Samantha
authors.initials: S
authors.lastname: Hendren
authors.forename: Marty
authors.initials: M
authors.lastname: Weiser
authors.forename: Jennifer
authors.initials: J
authors.lastname: Irani
authors.forename: W Donald
authors.initials: WD
authors.lastname: Buie
authors.forename: Janice F
authors.initials: JF
authors.lastname: Rafferty
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D002272:Carcinoembryonic Antigen / Q000097:blood; D059248:Chemoradiotherapy; D003082:Colectomy; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D013505:Digestive System Surgical Procedures; D004724:Endoscopy; D019160:Endosonography; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D010349:Patient Compliance; D012007:Rectum / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D002272:Carcinoembryonic Antigen