Colorectal cancer follow-up: Useful or useless?

Summary 

Follow-up of surgically treated colorectal cancer patients is not supported by objectively certain data. Despite the thousands of investigations reported in the scientific literature, only six randomized prospective studies and two meta-analysis of randomized studies provide data suggesting clear conclusions.

Our review of the literature revealed that intensive colorectal follow-up should be performed even if the long-term survival benefit is small. The timing and investigations conducted in follow-ups diverge. The inconsistency of follow-ups is revealed by the fact that the leading USA and European societies propose different guidelines. One datum that the literature agrees on is that pancolonoscopy performed at 3–5 year intervals in colorectal cancer surgery patients supports diagnosis of adenomatous polyps and metachronous cancers.

Cost analysis have shown that intensive follow-up would certainly exceed the cut-off point level set for every additional year of good quality of life.

Keywords: Colorectal cancer, Follow-up, Guidelines, Costs