More than 140,000 people in the United States are diagnosed annually with colorectal cancer.1 Unfortunately, ~25% to 40% will develop a tumor recurrence despite a potentially curative operation. Although it is well known that most recurrences occur within 5 years, the optimal strategy to accurately detect recurrences at the earliest stage remains controversial.
The current recommendations for follow-up surveillance include a combination of history and physical examination, laboratory evaluation, imaging, and endoscopy on slightly varying schedules depending on the organization and stage of disease.3–10 Further surveillance depends on the results of these examinations. Differing opinions also exist as to the cost-benefit as it relates to outcomes of high- versus low-intensity surveillance.2,11–28 Potential benefits of high-intensity surveillance include earlier detection of recurrence, higher rates of reoperation for cure, and improved overall and disease-specific survival. Yet, these conceivable benefits must be weighed against potential negative physical (ie, more invasive testing), financial, and psychological consequences of surveillance.
All ASCRS Clinical Practice Guidelines can be reviewed including the new Practice Guideline for the Surveillance of Patients After Curative Treament of Colon and Rectal Cancer.