This is the current release of the guideline.

The rating schemes for the level and grade of the evidence are provided at the end of the "Major Recommendations" field.

Recommendations

• Offering follow-up for patients with completely resected colorectal cancer is justified (Evidence Level I; Grade B)
• Routine office visits should be part of a follow-up program for patients who have completed treatment for colon and rectal cancer (Level II, Grade A)
• Serum hemoglobin, Hemoccult II, and liver function tests (hepatic enzymes tests) should not be routine components of a follow-up program (Level II, Grade A)
• Carcinoembryonic antigen (CEA) should be used as a part of follow-up for colorectal cancer; the use of other tumor markers remains experimental (Level II, Grade B)
• There is insufficient data to recommend for or against chest x-ray (CXR) as part of routine colorectal cancer follow-up (Level II, Grade C)
• Routine use of hepatic imaging studies in the follow-up of colorectal cancer should not be performed (Level II, Grade B)
• Periodic anastomotic evaluation is recommended for patients who have undergone resection/anastomosis or local excision of rectal cancer (Level III, Grade B)
• Data concerning proper timing of office visits, CEA, and chest x-ray is insufficient to recommend one particular schedule of follow-up over another; however, office visits and CEA evaluations should be performed at a minimum of three times per year for the first two years of follow-up (Level II, Grade A)
• Complete visualization of the colon should be performed if practical in all patients being considered for colon or rectal cancer resection; posttreatment colonoscopy should be performed at three-year intervals (Level III, Grade A)

Definitions:

Levels of Evidence

Level I: Evidence from properly conducted randomized, controlled trials

Level II: Evidence from controlled trials without randomization
or
Cohort or case-control studies
or
Multiple time series, dramatic uncontrolled experiments

Level III: Descriptive case series, opinions of expert panels

Scale Used for Evidence Grading

Grade A: High-level (level I or II), well-performed studies with uniform interpretation and conclusions by the expert panel

Grade B: High-level, well-performed studies with varying interpretations and conclusions by the expert panel

Grade C: Lower level evidence (level II or less) with inconsistent findings and/or varying interpretations or conclusions by the expert panel

None provided

The type of evidence supporting each recommendation is identified and graded (see "Major Recommendations" section).

Not applicable: The guideline was not adapted from another source.

2004 Jun

American Society of Colon and Rectal Surgeons - Medical Specialty Society

American Society of Colon and Rectal Surgeons

The Standards Practice Task Force

Task Force Members: Thomas Anthony, MD; Clifford Simmang, MD; Neil Hyman, MD; Donald Buie, MD; Donald Kim, MD; Peter Cataldo, MD; Charles Orsay, MD; James Church, MD; Daniel Otchy, MD; Jeffery Cohen, MD; W. Brian Perry, MD; Gary Dunn, MD; Janice Rafferty, MD; C. Neal Ellis, MD; Jan Rakinic, MD; Phillip Fleshner, MD; Thomas Stahl, MD; Sharon Gregorcyk, MD; Charles Ternent, MD; John W. Kilkenny III, MD; Mark Whiteford, MD

Not stated

This is the current release of the guideline.

None available

None available

This NGC summary was completed by ECRI on October 19, 2004.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.