In a nutshell
This article evaluated how surveillance colonoscopies (SC) were used in colorectal cancer patients previously treated with surgery. The main finding was that many patients who had curative surgery (complete removal of the cancer) underwent SC more often than recommended by the guidelines.
Some background
Patients who undergo curative surgery for CRC are usually followed-up regularly using SC. A colonoscopy uses a thin, flexible tube with a camera (colonoscope) which allows the doctor to look inside the large intestine (colon), from the rectum to the lower end of the small intestine. This procedure detects abnormal growths, ulcers, bleeding or inflamed tissue. Early detection of cancer recurrences using SC allows effective treatment.
Current guidelines recommend that patients who underwent surgery with curative intent for CRC have the first follow-up colonoscopy 1 year after treatment. If this examination is normal, the next SC should be performed after 3 more years and then every 5 years. Rare, but severe complications from colonoscopy include bleeding and perforation of the intestine which may require further surgery to repair the tear. For this reason, SC should be recommended with caution in older patients with additional illness.
Methods & findings
This study included 70419 patients who underwent curative surgery for CRC between 1992 and 2005. The authors analyzed the timing for the first 3 colonoscopies performed after surgery. The study found that ~17.5% of patients never underwent a SC and another 14.8% with a normal first colonoscopy never underwent a second one.
On the other hand, 32.1% of patients with a normal first SC underwent a second colonoscopy within 2 years after the first procedure. 27.3% of patients with a normal second SC underwent the third colonoscopy within 2 years after the second one. Moreover, 23.6% of patients over 80 underwent a repeat colonoscopy within 2 years of follow up with no clear indication.
The bottom line
In conclusion, this study showed that many patients who undergo curative surgery for CRC receive surveillance colonoscopy more often than recommended by current guidelines.
The fine print
However, this study included only patients older than 66 years. Further studies are necessary to determine SC trends in the younger population.
What’s next?
You should ask your doctor about the appropriate follow-up plan for you.
Published By :
Clinical Gastroenterology and Hepatology
Date :
Jan 01, 2013
