Trends in surveillance for resected colorectal cancer, 2001‐2009. Issue 19 (16th June 2015)

• Record Type: Journal Article
• Authors: Paulson, E. Carter; Veenstra, Christine M.; Vachani, Anil; Ciunci, Christine A.; Epstein, Andrew J.
• Is Part Of: Cancer. Volume 121:Issue 19(2015)
• Page Start: 3525
• Page End: 3533
• Publication Date: 2015-06-16
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29469
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29469-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Little is known about recent trends in surveillance among the more than 1 million US colorectal cancer (CRC) survivors. Moreover, for stage I disease, which accounts for more than 30% of survivors, the guidelines are limited, and the use of surveillance has not been well studied. Guidelines were changed in 2005 to include recommendations for computed tomography (CT) surveillance in select patients, but the impact of these changes has not been explored.</p> </sec> <sec id="cncr29469-sec-0002" sec-type="section"> <title>METHODS</title> <p>A retrospective analysis of patients who were identified in the Survival, Epidemiology, and End Results–Medicare database and underwent resection of stage I to III CRC between 2001 and 2009 was performed. The receipt of guideline‐determined sufficient surveillance, including office visits, colonoscopy, carcinoembryonic antigen (CEA) testing, and CT imaging, in the 3 years after resection was evaluated.</p> </sec> <sec id="cncr29469-sec-0003" sec-type="section"> <title>RESULTS</title> <p>The study included 23, 990 colon cancer patients and 5665 rectal cancer patients. Rates of office visits and colonoscopy were high and stable over the study period. Rates of CEA surveillance increased over the study period but remained low, even for stage III disease. Rates of CT imaging increased gradually during the study period, but the 2005 guideline change had no effect. Stage II patients, including high‐risk patients, received surveillance at significantly lower rates than stage III patients despite similar recommendations. Conversely, up to 30% of stage I patients received nonrecommended CEA testing and CT imaging.</p> </sec> <sec id="cncr29469-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>There continues to be substantial underuse of surveillance for CRC survivors and particularly for stage II patients, who constitute almost 40% of survivors. The 2005 guideline change had a negligible impact on CT surveillance. Conversely, although guidelines are limited, many stage I patients are receiving intensive surveillance. <bold><italic>Cancer</italic> 2015;121:3435–43.</bold> © <italic>2015 American Cancer Society</italic>.</p> </sec> </abstract>