Colonoscopy Surveillance After Colorectal Cancer Resection

GUIDELINE TITLE Colonoscopy Surveillance After Colorectal Cancer Resection RELEASE DATE January 2016 (online); March 2016 (print) DEVELOPER US Multi-Society Task Force (USMSTF) on Colorectal Cancer PRIOR VERSION March 2006 FUNDING SOURCE USMSTF TARGET POPULATION Adult patients who have under gone surgical resection for TNM stages I-III (or Dukes A-C) colorectal cancer(CRC) without Lynch syndrome and select patients with stage IV disease MAJOR RECOMMENDATIONS Patients who undergo surgical resection of obstructing CRC should have a high-quality colonoscopy within 3 to 6 months of surgery (strong recommendation; low-quality evidence). Patients with colon or rectal cancer should have a surveillance colonoscopy 1 year after surgery; for patients with obstructive disease, 1 year after perioperative colonoscopy (strong recommendation; low-quality evidence). After the first surveillance colonoscopy, patients should have a second colonoscopy 3 years later. Subsequent colonoscopies should occur at 5-year intervals until the benefit of continued surveillance is outweighed by diminishing life expectancy (strong recommendation; low-quality evidence). If patients with obstructive CRC are unable to undergo colonoscopy, computed tomographic colonography (CTC) is the best alternative. Double-contrast barium enema is appropriate if CTC is not available (strong recommendation; moderate-quality evidence). Patients with localized rectal cancer who have undergone surgical resection should undergo local surveillance with flexible sigmoidoscopy or endoscopic ultrasound (EUS) every 3 to 6 months for the first 2 to 3 years after surgery (weak recommendation; low-quality evidence).