Followup tests after stages I-II-III colon or rectal cancer
After you finish treatment for colon or rectal cancer that has not spread beyond lymph nodes (stages I,II,or III), you’ll want to follow-up regularly with your doctor for several years to:
- Watch for polyps or a second colorectal cancer
- Find cancer recurrence, particularly if surgery to remove a local recurrence or new tumors is possible.
An expert panel of doctors recommends the following tests.
- CEA (carcinoembyonic antigen) blood test every 3 months for 2 years, then every 6 months for 5 years for T2,T3, or T4 tumors.
- If cancer blocked the flow of feces (obstruction) so that colonoscopy could not be completed before surgery, a colonoscopy to remove all additional polyps (clearing colonoscopy) should be done during surgery or 3 to 6 months after surgery
- For patients who have a high risk of recurrence, chest, abdominal, and pelvic CT scans may be considered once a year for 3 years.
- PET scans are not recommended.
- Colonoscopy should be done 1 year after surgery for colon or rectal cancer. If normal, repeat it in 3 years and then at 5 years. If abnormal repeat in 1 year.
- Multiple polyps, polyps 1 centimeter or larger, or polyps with dangerous features call for more frequent follow-up colonoscopy.
- Patients with a positive family history for Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC) should have follow-up colonoscopies every 1 to 2 years.
- Patients with rectal cancer should have exams with flexible sigmoidoscopy or endoscopic ultrasound every 3 to 6 months for 2 to 3 years to detect possible local recurrence in the rectum.
Where Can You Go for More Information?
Colon and Rectal Cancer Treatment Guidelines for Patients, National Comprehensive Cancer Network and American Cancer Society, Version V, October 2007.
Colonoscopy Surveillance after Polypectomy and Colorectal Cancer Resection, Consensus Guidelines from the U.S. Multi-Society Task Force on Colorectal Cancer and the American Cancer Society (2008).
Last Update: April 24, 2008
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