Table 2.
Summary of Recommended Surveillance Protocols
| Test/Procedure | ASCRS12 | NCCN23 | ASCO24 |
|---|---|---|---|
| History and physical exam | Minimum of 3 times/year for the first 2 y | Every 3–6 mo for 2 y, then every 6 mo for 5 y | Every 3–6 mo for 3 y, every 6 mo years 4 & 5, then physician discretion |
| Fecal occult blood test | Not recommended | Not addressed | Not addressed |
| Complete blood count | Not recommended | Not addressed | Not recommended |
| Liver function tests | Not recommended | Not addressed | Not recommended |
| Carcinoembryonic antigen | Minimum of 3 times/year for the first 2 years | Every 3–6 mo for 2 y, then every 6 mo for 5 y for T2 or greater | Every 3 mo for 3 y or longer |
| Chest radiography | Not recommended | Not recommended | Not recommended |
| Flexible sigmoidoscopy/ proctoscopy, endoscopic ultrasound | Periodic anastomotic evaluation recommended (patients who have undergone resection/anastomosis or local excision of rectal cancer) | Consider proctoscopy every 6 mo × 5 y | Flexible proctoscope/sigmoidoscopy every 6 mo × 5 y for patients who have not received pelvic irradiation |
| Colonoscopy | Every 3 years following primary therapy | 1 y after primary therapy, then at 3 y & every 5 y (repeat in 1 y if abnormal) | At 3 y, then every 5 y if normal |
| Computed tomography of chest/abdomen/pelvis | Not recommended | Annually × 3 y for patients at higher risk of recurrence (lymphovascular invasion, poor differentiation) | Annually × 3 y for patients at higher risk recurrence (lymphovascular invasion, poor differentiation) |
| Abdominal ultrasound | Not recommended | Not addressed | Not addressed |
ASCRS, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons; NCCN, National Cancer Care Network; ASCO, the American Society of Clinical Oncology.