For Colorectal Patients, Surgery May Not Be Enough

Colorectal cancer patients may need colonoscopy after surgery

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) A colonoscopy is a medical procedure that uses a thin, flexible tube to examine the colon. Although invasive and sometimes uncomfortable, colonoscopies are essential screening tools. And that may be especially true for colorectal cancer patients.

According to new recommendations from the US Multi-Society Task Force on Colorectal Cancer, it is extremely important that colorectal cancer patients get a colonoscopy after surgery in order to catch any new cancer that may have grown and to remove any remaining polyps.

This recommendation is based on evidence that suggests that patients who receive a colonoscopy after colorectal cancer surgery have a significantly higher survival rate. Between 0.7 and 7 percent of colorectal cancer patients have a second cancer that has grown simultaneously, according to the agency.

Among cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related death in the US, according to the Centers for Disease Control and Prevention (CDC). However, about 9 out of 10 colorectal cancer patients whose disease is caught early are still alive five years later.

The Task Force recommends that patients who have undergone colorectal cancer surgery receive colonoscopies on the following schedule: Before surgery or within three to six months after surgery, and after one, four and nine years. Patients should then continue to have colonoscopies every five years, until life expectancy outweighs the procedure’s benefits.

The Task Force noted that rectal cancer patients have a higher risk of cancer recurrence than colon cancer patients, especially if the cancer was not treated with chemotherapy and radiation before surgery.

In addition to scheduled colonoscopies, patients at high risk of cancer recurrence should have local surveillance every three to six months for the first two to three years after surgery.

According to the new recommendations, there is little evidence to support fecal immunochemical tests (FIT) or fecal DNA tests after colorectal cancer surgery. However, the CDC reports that there are several screening tests currently under study.

The new recommendations were published simultaneously Feb. 16 inGastroenterology, the American Journal of Gastroenterology and Gastrointestinal Endoscopy.

No funding sources and conflicts of interest were disclosed.

Review Date: 
February 18, 2016
Last Updated:
February 19, 2016