There continues to be substantial underuse of surveillance for survivors of colorectal cancer, particularly for stage II patients, a new study published online ahead of print in the journal Cancer has shown.

For the study, researchers conducted a retrospective analysis of 23,990 patients with colon cancer and 5,665 patients with rectal cancer who were identified in the Survival, Epidemiology, and End Results (SEER)-Medicare database. All patients had undergone resection of stage I to III colorectal cancer between 2001 and 2009.

Results showed that rates of office visits and colonoscopy were high and stable over the study period, while rates of carcinoembryonic antigen (CEA) testing remained low despite increasing, even for patients with stage III disease.

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Researchers found that rates of CT imaging gradually increased over the study period, but the 2005 guideline change to include recommendations for CT surveillance in select patients had no effect.

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Despite similar guideline recommendations, patients with stage II disease, including those at high-risk, received surveillance at significantly lower rates than those with stage III disease.

Furthermore, the study showed that up to 30% of patients with stage I colorectal cancer underwent nonrecommended CEA testing and CT imaging.


  1. Paulson EC, Veenstra CM, Vachani A, et al. Trends in surveillance for resected colorectal cancer. Cancer. 2015. [Epub ahead of print]. doi: 10.1002/cncr.29469.