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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

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  GASTROINTESTINAL CANCER


Minerva Gastroenterologica e Dietologica 2009 December;55(4):483-500

language: English

Surveillance approaches among colorectal cancer survivors after curative-intent

Haggstrom D. A. 1-4, Imperiale T. F. 1,2,4,5

1 VA Health Services Research & Development (HSR&D) Center on Implementing Evidence-based Practice (CIEBP), Roudebush VAMC, Indianapolis, IN, USA
2 Regenstrief Institute, Inc., Indianapolis, IN, USA
3 Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine (IUSOM)
Indianapolis, IN, USA
4 Indiana University Simon Cancer Center, Indianapolis, IN, USA
5 Division of Gastroenterology, Department of Medicine, IUSOM, Indianapolis, IN, USA


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Intensive surveillance among colorectal cancer patients receiving curative-intent, particularly during the first 2 to 3 years of follow-up, has a beneficial impact upon all-cause survival at five years. Intensive surveillance appears to be associated with the early detection of recurrences, and more often accompanied by a clinical presentation enabling surgical resection. The optimal combination and frequency of surveillance tests is unknown. Imaging of the chest and abdomen have increasingly been recommended by professional organizations, in addition to CEA levels, in order to detect resectable recurrences. Metachronous cancers are relatively uncommon, nonetheless, surveillance colonoscopy is typically recommended. Cau-tion is warranted in further advancing the intensity of surveillance, as increasingly aggressive surveillance programs risk increased detection of pseudodisease. Different types of information will enhance our understanding of the impact of follow-up programs, including data regarding quality of life, cost, and patient preferences.

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dahaggst@iupui.edu