Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer

American society of clinical oncology clinical practice guideline endorsement

Jeffrey A. Meyerhardt, Pamela B. Mangu*, Patrick J. Flynn, Larissa Korde, Charles L. Loprinzi, Bruce D. Minsky, Nicholas J. Petrelli, Kim Ryan, Deborah H. Schrag, Sandra L. Wong, Al B Benson III

*Corresponding author for this work

Research output: Contribution to journalArticle

144 Citations (Scopus)

Abstract

Purpose The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing recent clinical practice guidelines that have been developed by other professional organizations. Methods The Cancer Care Ontario (CCO) Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer was reviewed by ASCO for methodologic rigor and considered for endorsement. Results The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements. Conclusion Surveillance should be guided by presumed risk of recurrence and functional status of the patient (important within the first 2 to 4 years). Medical history, physical examination, and carcinoembryonic antigen testing should be performed every 3 to 6 months for 5 years. Patients at higher risk of recurrence should be considered for testing in the more frequent end of the range. A computed tomography scan (abdominal and chest) is recommended annually for 3 years, in most cases. Positron emission tomography scans should not be used for surveillance outside of a clinical trial. A surveillance colonoscopy should be performed 1 year after the initial surgery and then every 5 years, dictated by the findings of the previous one. If a colonoscopy was not preformed before diagnosis, it should be done after completion of adjuvant therapy (before 1 year). Secondary prevention (maintaining a healthy body weight and active lifestyle) is recommended. If a patient is not a candidate for surgery or systemic therapy because of severe comorbid conditions, surveillance tests should not be performed. A treatment plan from the specialist should have clear directions on appropriate follow-up by a nonspecialist.

Original languageEnglish (US)
Pages (from-to)4465-4470
Number of pages6
JournalJournal of Clinical Oncology
Volume31
Issue number35
DOIs
StatePublished - Dec 10 2013

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Aftercare
Medical Oncology
Secondary Prevention
Practice Guidelines
Survivors
Colorectal Neoplasms
Ontario
Colonoscopy
Recurrence
Carcinoembryonic Antigen
Positron-Emission Tomography
Physical Examination
Life Style
Neoplasms
Thorax
Therapeutics
Tomography
Body Weight
Clinical Trials
Guidelines

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Meyerhardt, Jeffrey A. ; Mangu, Pamela B. ; Flynn, Patrick J. ; Korde, Larissa ; Loprinzi, Charles L. ; Minsky, Bruce D. ; Petrelli, Nicholas J. ; Ryan, Kim ; Schrag, Deborah H. ; Wong, Sandra L. ; Benson III, Al B. / Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer : American society of clinical oncology clinical practice guideline endorsement. In: Journal of Clinical Oncology. 2013 ; Vol. 31, No. 35. pp. 4465-4470.
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title = "Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American society of clinical oncology clinical practice guideline endorsement",
abstract = "Purpose The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing recent clinical practice guidelines that have been developed by other professional organizations. Methods The Cancer Care Ontario (CCO) Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer was reviewed by ASCO for methodologic rigor and considered for endorsement. Results The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements. Conclusion Surveillance should be guided by presumed risk of recurrence and functional status of the patient (important within the first 2 to 4 years). Medical history, physical examination, and carcinoembryonic antigen testing should be performed every 3 to 6 months for 5 years. Patients at higher risk of recurrence should be considered for testing in the more frequent end of the range. A computed tomography scan (abdominal and chest) is recommended annually for 3 years, in most cases. Positron emission tomography scans should not be used for surveillance outside of a clinical trial. A surveillance colonoscopy should be performed 1 year after the initial surgery and then every 5 years, dictated by the findings of the previous one. If a colonoscopy was not preformed before diagnosis, it should be done after completion of adjuvant therapy (before 1 year). Secondary prevention (maintaining a healthy body weight and active lifestyle) is recommended. If a patient is not a candidate for surgery or systemic therapy because of severe comorbid conditions, surveillance tests should not be performed. A treatment plan from the specialist should have clear directions on appropriate follow-up by a nonspecialist.",
author = "Meyerhardt, {Jeffrey A.} and Mangu, {Pamela B.} and Flynn, {Patrick J.} and Larissa Korde and Loprinzi, {Charles L.} and Minsky, {Bruce D.} and Petrelli, {Nicholas J.} and Kim Ryan and Schrag, {Deborah H.} and Wong, {Sandra L.} and {Benson III}, {Al B}",
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Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer : American society of clinical oncology clinical practice guideline endorsement. / Meyerhardt, Jeffrey A.; Mangu, Pamela B.; Flynn, Patrick J.; Korde, Larissa; Loprinzi, Charles L.; Minsky, Bruce D.; Petrelli, Nicholas J.; Ryan, Kim; Schrag, Deborah H.; Wong, Sandra L.; Benson III, Al B.

In: Journal of Clinical Oncology, Vol. 31, No. 35, 10.12.2013, p. 4465-4470.

Research output: Contribution to journalArticle

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T1 - Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer

T2 - American society of clinical oncology clinical practice guideline endorsement

AU - Meyerhardt, Jeffrey A.

AU - Mangu, Pamela B.

AU - Flynn, Patrick J.

AU - Korde, Larissa

AU - Loprinzi, Charles L.

AU - Minsky, Bruce D.

AU - Petrelli, Nicholas J.

AU - Ryan, Kim

AU - Schrag, Deborah H.

AU - Wong, Sandra L.

AU - Benson III, Al B

PY - 2013/12/10

Y1 - 2013/12/10

N2 - Purpose The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing recent clinical practice guidelines that have been developed by other professional organizations. Methods The Cancer Care Ontario (CCO) Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer was reviewed by ASCO for methodologic rigor and considered for endorsement. Results The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements. Conclusion Surveillance should be guided by presumed risk of recurrence and functional status of the patient (important within the first 2 to 4 years). Medical history, physical examination, and carcinoembryonic antigen testing should be performed every 3 to 6 months for 5 years. Patients at higher risk of recurrence should be considered for testing in the more frequent end of the range. A computed tomography scan (abdominal and chest) is recommended annually for 3 years, in most cases. Positron emission tomography scans should not be used for surveillance outside of a clinical trial. A surveillance colonoscopy should be performed 1 year after the initial surgery and then every 5 years, dictated by the findings of the previous one. If a colonoscopy was not preformed before diagnosis, it should be done after completion of adjuvant therapy (before 1 year). Secondary prevention (maintaining a healthy body weight and active lifestyle) is recommended. If a patient is not a candidate for surgery or systemic therapy because of severe comorbid conditions, surveillance tests should not be performed. A treatment plan from the specialist should have clear directions on appropriate follow-up by a nonspecialist.

AB - Purpose The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing recent clinical practice guidelines that have been developed by other professional organizations. Methods The Cancer Care Ontario (CCO) Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer was reviewed by ASCO for methodologic rigor and considered for endorsement. Results The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements. Conclusion Surveillance should be guided by presumed risk of recurrence and functional status of the patient (important within the first 2 to 4 years). Medical history, physical examination, and carcinoembryonic antigen testing should be performed every 3 to 6 months for 5 years. Patients at higher risk of recurrence should be considered for testing in the more frequent end of the range. A computed tomography scan (abdominal and chest) is recommended annually for 3 years, in most cases. Positron emission tomography scans should not be used for surveillance outside of a clinical trial. A surveillance colonoscopy should be performed 1 year after the initial surgery and then every 5 years, dictated by the findings of the previous one. If a colonoscopy was not preformed before diagnosis, it should be done after completion of adjuvant therapy (before 1 year). Secondary prevention (maintaining a healthy body weight and active lifestyle) is recommended. If a patient is not a candidate for surgery or systemic therapy because of severe comorbid conditions, surveillance tests should not be performed. A treatment plan from the specialist should have clear directions on appropriate follow-up by a nonspecialist.

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