TABLE 3.
Follow-up guidelines of main professional societies
| Modality | ASCO47 | NCCN48,49 | ESMO50,51 |
|---|---|---|---|
| History, physical exam | Every 3–6 m for 3 y, then every 6 m up to 5 y | Every 3–6 m for 2 y, then every 6 m up to 5 y | every 3–6 m for 3 y, then every 6–12 m for 2 y (colon) every 6 m for 2 y (rectal cancer) |
| Colonoscopy | at 3y, every 5y thereafter | At 1y, then at 3y, every 5y thereafter | After 1y, then every 3y (colon) every 5y (rectal cancer) |
| Flexible proctoscopy (rectal cancer) | every 6m for 5y (for not irradiated patients) | every 6m for 5y (for patients with LAR) | every 6 m for 2 years |
| Blood tests | not recommended | not recommended | not recommended |
| CEA | every 3–6m for 3y (stage II and III) | every 3–6m for 2y, then every 6m up to 5y (staged as T2 or greater) | if initially elevated: every 3–6m for 3y, then every 6–12m for 2y (colon) not recommended (rectal cancer) |
| Chest x-rays | not recommended | not covered | not recommended |
| US abdomen | not covered | not covered | not recommended |
| CT thorax and CT abdomen | annually for 3y for pts with high risk of recurrence | annually for 3–5y for stage II and III | Every 6m for 3y for pts with high risk of recurrence (colon) Not recommended (rectal cancer) |
| Pelvic CT (rectal cancer) | negative prognostic features, especially for not irradiated pts (no frequency) | Not covered | not recommended |
Abbreviations: m=months; y=years; ASCO=American Society Clinical Oncology; NCCN=National Comprehensive Cancer Network; ESMO=European Society Medical Oncology