Surveillance should be planned according to presumed risk of recurrence, patients' functional status
THURSDAY, Nov. 14 (HealthDay News) -- The American Society of Clinical Oncology (ASCO) has endorsed Cancer Care Ontario (CCO) guidelines for colorectal cancer survivor follow-up care, according to a study published online Nov. 12 in the Journal of Clinical Oncology.
Jeffrey A. Meyerhardt, M.D., M.P.H., from the Dana-Faber Cancer Institute in Boston, and colleagues from an ASCO panel considered endorsement of the CCO Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer.
The ASCO agreed with the CCO recommendations, and recommended endorsement with incorporation of qualifying statements. Surveillance should be guided by the assumed risk of recurrence and patients' functional status. For five years, medical history, physical examination, and carcinoembryonic antigen testing should be conducted every three to six months, with testing recommended in the more frequent range for patients at higher risk of recurrence. In most cases, a computed tomography scan (abdomen and chest) should be performed annually for three years. Outside of a clinical trial, positron emission tomography scans should not be used for surveillance. One year after the initial surgery and every five years thereafter the patient should undergo surveillance colonoscopy. Colonoscopy should be performed after completion of adjuvant therapy (before one year) if it was not done before diagnosis. Maintenance of a healthy weight and an active lifestyle are recommended for secondary prevention. Surveillance tests should not be performed if the patient is not a candidate for surgery or systemic therapy due to severe comorbid conditions.
"The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements," the authors write.
Abstract (http://jco.ascopubs.org/content/early/2013/11/04/JCO.2013.50.7442.abstract )Full Text (http://jco.ascopubs.org/content/early/2013/11/04/JCO.2013.50.7442.full.pdf+html )