Colorectal cancer patients who undergo colonoscopic surveillance during follow-up after surgery experience improved survival, according to a study to be published in the April issue of Clinical Gastroenterology and Hepatology but currently available on-line. Results of the study suggest that colorectal cancer patients should undergo routine colonoscopic surveillance at one year after their surgery and that more intensive surveillance may be needed in patients found to have advanced neoplasia as well as those with a prior history of adenomatous colon polyps.
"The results of our study provide additional evidence that colorectal cancer survivors benefit from surveillance with colonoscopy, and it appears that the initial surveillance colonoscopy should be performed at one year after colon resection because of the significant risk of additional cancers and polyps in these patients," according to Stephen J. Rulyak, MD, MPH, lead author of the study and Acting Assistant Professor in the Division of Gastroenterology at the University of Washington in Seattle.
The study included a total of 1,002 patients identified from the Group Health Cooperative, a large health system in Washington State, and consisted of equal proportions of men and women, the majority of whom were aged 60 years or older. More than 700 (70 percent) were alive at the end of the study period and the cumulative survival for the study group was 96 percent at one year and 68 percent at five years.
Patients who underwent one or more colon examinations during follow-up had improved survival compared with patients who did not undergo examination (652 patients versus 350 patients). Patients estimated five-year survival was similar regardless of whether the initial follow-up colon exam was performed within 18 months of diagnosis (78.0 percent), between 18 and 35 months of diagnosis (75.5 percent) or between 36 and 60 months of diagnosis (77.3 percent). However, among patie
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American Gastroenterological Association