Evaluating adherence to post-treatment surveillance of colorectal cancer at a reference center in Mexico: A retrospective analysis.

Abstract

Purpose: After colorectal cancer (CCR) treatment, adequate follow-up is recommended to improve overall survival. We aimed to assess the adherence to the National Comprehensive Cancer Network clinical practice guidelines on post-treatment surveillance for CRC at the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, Mexico. Methods: We included patients with stage I-III CRC treated between January 2014 and December 2016. We evaluated adherence to surveillance during the first three years after completion of CRC treatment or until recurrence, whichever came first. We defined adequate compliance with guidelines as ≥2 physician visits annually for three years, ≥2 serum carcinoembryonic antigen blood tests annually for two years, and at least one colonoscopy during the three-year surveillance period. Results: Overall-three-year adherence to surveillance recommendations was 53.8% (n=49). Colonoscopy was the component with the highest adherence with 91.2% (n=83) of the patients, followed by medical visits with 71.4% (n=65) of the patients. During the three-year period of follow-up, 23% (n=21) of patients lost follow-up. Three-year recurrence rate was 6.6% (n=6). In a bivariate analysis, we did not find any significant association between clinical and demographic factors and adherence to surveillance.Conclusions: At our institution, compliance to the guidelines on post-treatment surveillance is higher than the reported at similar centers in other world regions, though there is a decreasing trend in adherence during the study period. More evidence is needed to understand the potential barriers to surveillance and implement strategies to improve compliance to surveillance and the survival of patients.