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 three months for two years, then every six months for five 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 three to six 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 three years.
- PET scans are not recommended.
- Colonoscopy should be done one year after surgery for colon or rectal cancer. If normal, repeat it in three years and then at five years. If abnormal repeat in one year.
- Multiple polyps, polyps one 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 one to two years.
- Patients with rectal cancer should have exams with flexible sigmoidoscopy or endoscopic ultrasound every three to six months for two to three years to detect possible local recurrence in the rectum.
Where Can You Go for More Information?
What to Know: ASCO’s Guideline on Follow-Up Care for Colorectal Cancer is a well-written, patient-friendly description of what ASCO experts have agreed on is the best follow-up care plan for people who have finished their cancer treatment.
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).