Last updated March 14, 2022

Surveillance and Survivorship Care of Patients After Curative Treatment of Colon and Rectal Cancer

Recommendation

Risk Assessment and Stratification

1. Surveillance after resection of nonmetastatic colon or rectal cancer should be tailored to the relative risk of recurrence based on clinical and pathologic prognostic indicators. (2C)
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2. A risk-adapted surveillance strategy should be considered for patients with nonmetastatic colon or rectal cancer who did not receive guideline-recommended cancer treatment. (2B)
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Surveillance

3. Surveillance is recommended for patients with stage II and III colon or rectal cancer who have undergone resection with curative intent. (1A)
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4. Surveillance is recommended for patients with stage IV colon or rectal cancer who have undergone therapy with curative intent. (1C)
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5. After treatment for stage I colon or rectal cancer, selected patients should be considered for surveillance. (2C)
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6. After completing treatment for stage II/III colon or rectal cancer, regularly scheduled office visits and CEA testing should typically be included as a part of a comprehensive surveillance strategy. (1A)
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7. After completing treatment for stage II/III colon or rectal cancer, radiographic surveillance should typically include cross-sectional chest and abdominopelvic CT imaging. (1A)
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8. Surveillance colonoscopy is typically recommended 1 year after completing treatment for stage II/III colon or rectal cancer. In patients with an incomplete preoperative evaluation, completion colonoscopy should typically be performed within 6 months of resection or on the completion of adjuvant therapy. (1B)
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9. Surveillance proctosigmoidoscopy with or without endorectal ultrasound is recommended for patients with rectal cancer who have undergone local excision or resection with curative intent with an anastomosis. (2B)
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Survivorship

10. A survivorship care plan is recommended for patients after colon or rectal cancer resection and should typically include a treatment summary, a plan for follow-up care, and information about common late and long-term adverse effects associated with the treatment received. (1B)
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11. After completing treatment for colon or rectal cancer, patients should typically be assessed for psychosocial morbidity (eg, adverse lifestyle behaviors, cognitive dysfunction, or fear of recurrence causing distress) and offered appropriate treatment. (1B)
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12. After completing treatment for colon or rectal cancer, patients should be assessed and treated for late and long-term treatment-related symptoms including functional impairment (eg, peripheral sensory neuropathy and bowel, urinary, and sexual dysfunction). (1B)
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Recommendation Grading

Overview

Title

Surveillance and Survivorship Care of Patients After Curative Treatment of Colon and Rectal Cancer

Authoring Organization

Publication Month/Year

May 1, 2021

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient

Intended Users

Physician, nurse practitioner, nurse

Scope

Assessment and screening, Prevention, Management

Diseases/Conditions (MeSH)

D003106 - Colon

Keywords

colorectal cancer, Clinical Practice Guidelines, Colon and Rectal Cancer, Surveillance and Survivorship Care

Methodology

Number of Source Documents
130
Literature Search Start Date
January 1, 1950
Literature Search End Date
October 6, 2020