Guidelines for colonoscopy surveillance after cancer resection: A consensus update by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer Journal Article
| Authors: | Rex, D. K.; Kahi, C. J.; Levin, B.; Smith, R. A.; Bond, J. H.; Brooks, D.; Burt, R. W.; Byers, T.; Fletcher, R. H.; Hyman, N.; Johnson, D.; Kirk, L.; Lieberman, D. A.; Levin, T. R.; O'Brien, M. J.; Simmang, C.; Thorson, A. G.; Winawer, S. J. |
| Article Title: | Guidelines for colonoscopy surveillance after cancer resection: A consensus update by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer |
| Abstract: | Patients with resected colorectal cancer are at risk for recurrent cancer and metachronous neoplasms in the colon. This joint update of guidelines by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer addresses only the use of endoscopy in the surveillance of these patients. Patients with endoscopically resected Stage I colorectal cancer, surgically resected Stages II and III cancers, and Stage IV cancer resected for cure (isolated hepatic or pulmonary metastasis) are candidates for endoscopic surveillance. The colorectum should be carefully cleared of synchronous neoplasia in the perioperative period. In nonobstructed colons, colonoscopy should be performed preoperatively. In obstructed colons, double-contrast barium enema or computed tomography colonography should be performed preoperatively, and colonoscopy should be performed 3 to 6 months after surgery. These steps complete the process of clearing synchronous disease. After clearing for synchronous disease, another colonoscopy should be performed in 1 year to look for metachronous lesions. This recommendation is based on reports of a high incidence of apparently metachronous second cancers in the first 2 years after resection. If the examination at 1 year is normal, then the interval before the next subsequent examination should be 3 years. If that examination is normal, then the interval before the next subsequent examination should be 5 years. Shorter intervals may be indicated by associated adenoma findings (see "Guidelines for Colonoscopy Surveillance After Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society"). Shorter intervals also are indicated if the patient's age, family history, or tumor testing indicate definite or probable hereditary nonpolyposis colorectal cancer. Patients undergoing low anterior resection of rectal cancer generally have higher rates of local cancer recurrence compared with those with colon cancer. Although effectiveness is not proven, performance of endoscopic ultrasound or flexible sigmoidoscopy at 3- to 6-month intervals for the first 2 years after resection can be considered for the purpose of detecting a surgically curable recurrence of the original rectal cancer. © 2006 American Gastroenterological Association Institute. |
| Keywords: | treatment outcome; cancer surgery; cancer recurrence; united states; postoperative care; cancer staging; follow-up studies; cancer diagnosis; cancer incidence; neoplasm staging; sensitivity and specificity; colorectal cancer; computer assisted tomography; neoplasm recurrence, local; practice guideline; colorectal neoplasms; liver metastasis; lung metastasis; colonoscopy; family history; perioperative period; cancer epidemiology; age distribution; rectum cancer; polypectomy; sigmoidoscopy; colon; non profit organization; colectomy; barium enema; monitoring, physiologic |
| Journal Title: | Gastroenterology |
| Volume: | 130 |
| Issue: | 6 |
| ISSN: | 0016-5085 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2006-05-01 |
| Start Page: | 1865 |
| End Page: | 1871 |
| Language: | English |
| DOI: | 10.1053/j.gastro.2006.03.013 |
| PUBMED: | 16697749 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 105" - "Export Date: 4 June 2012" - "CODEN: GASTA" - "Source: Scopus" |
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