It is critically important that colorectal cancer patients undergo colonoscopy after surgery to ensure that they do not have a second colon cancer, and to find and remove any additional polyps.
According to new recommendations from the US Multi-Society Task Force on Colorectal Cancer, the evidence shows that post-operative colonoscopy is associated with improved overall survival for colorectal cancer patients.
Between 0.7 and 7 percent of colorectal cancer patients have a second, concurrent cancer.
These recommendations update the 2006 US Multi-Society Task Force consensus guideline, which addressed the use of endoscopy for patients after colorectal cancer resection.
The updated document focuses on the role of colonoscopy in these patients, as well as reviews possible adjunctive roles of faecal testing and CT colonography in post cancer resection patients.
Patients who have surgery to remove colorectal cancer should receive colonoscopy on the following schedule:
Subsequent colonoscopies should occur at five year intervals until the benefit of continuing surveillance is outweighed by diminishing life expectancy.
If pre-cancerous polyps are found, the intervals for surveillance should follow published guidelines for polyp surveillance.
This does not apply to patients with Lynch syndrome.
Additional considerations in surveillance of rectal cancer
Alternatives and adjuncts to colonoscopy
Colorectal cancer is the second leading cause of cancer death for both men and women combined in the US More than 132,000 new cases of colorectal cancer were estimated to be diagnosed in 2015 and of those, 70 to 80 percent were expected to undergo surgical resection with intent to cure the disease.
Up to 40 percent of patients with locoregional disease (recurrence at or near the original tumour site after removal) will develop recurrent cancer, 90 percent of which will occur within five years.
The US Multi-Society Task Force is composed of gastroenterology specialists with a special interest in colorectal cancer, representing the American Gastroenterological Association, the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy.
(27 May 2016)