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Colonoscopy Surveillance After Colorectal Cancer: the Optimal Interval for Follow-Up

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Abstract

Purpose

Patients who have undergone curative surgery for colorectal cancer are at risk of developing a metachronous colorectal tumour or anastomotic recurrence. The aim of this study was to determine the incidence of recurrent colorectal cancer in a cohort of patients who participated in a colonoscopy surveillance programme.

Methods

This single-centre retrospective observational cohort study included patients who underwent curative surgery for colorectal cancer between 2005 and 2015. All reports of postoperative colonoscopies were retrieved to calculate the incidence rates of recurrence and metachronous colorectal cancer.

Results

Of 2420 patients, 1644 (67.9%) underwent at least one postoperative colonoscopy and 776 (32.1%) did not. In 1087 patients, colonoscopy was performed in the first 18 months after surgery, which detected 34 (3.1%) instances of metachronous colorectal tumours or anastomotic recurrence. Thirty-three additional patients were also diagnosed with recurrent colorectal cancer, but the tumours were detected by other diagnostic modalities or detected perioperatively, rather than by colonoscopy.

Conclusions

Patients with a history of colorectal cancer have an increased risk for a second colorectal tumour. Therefore, we recommend a colonoscopic surveillance programme with the first colonoscopy performed 1 year after curative surgery, which is in accordance with national guidelines.

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Author information

Authors and Affiliations

  1. Department of Surgery, Amphia Hospital Breda, Molengracht 21, 4818 CK, Breda, The Netherlands

    Winesh Ramphal, Jeske R. E. Boeding, Jennifer M. J. Schreinemakers, Paul D. Gobardhan & Rogier M. P. H. Crolla

  2. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands

    Harm J. T. Rutten

  3. GROW: School of Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands

    Harm J. T. Rutten

Authors
  1. Winesh Ramphal
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  2. Jeske R. E. Boeding
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Corresponding author

Correspondence to Winesh Ramphal.

Ethics declarations

For ethical approval, we consulted the national institutional review board’s Medical research Ethics Committees United (MEC-U). Referring to this study (reference number W17.073), confirmation was received that the Medical Research Involving Human Subject Act (WMO) does not apply; therefore, official approval of this study by the MEC-U was not required under the WMO. We also consulted the institutional review board of Amphia Hospital (AMOA), and they confirmed that no formal written waiver of ethics approval was required, because of the retrospective design of the study.

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The authors declare that they have no conflict of interest.

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Appendix

Appendix

Table 4 Time intervals of patients receiving their second colonoscopy surveillance with tumour findings after first follow-up colonoscopy
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Table 5 Time intervals of patients receiving their third colonoscopy with tumour findings after follow-up colonoscopy
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Ramphal, W., Boeding, J.R.E., Schreinemakers, J.M.J. et al. Colonoscopy Surveillance After Colorectal Cancer: the Optimal Interval for Follow-Up. J Gastrointest Canc 51, 469–477 (2020). https://doi.org/10.1007/s12029-019-00254-5

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