Physician follow-up and observation of guidelines in the post treatment surveillance of colorectal cancer

Vargas, Gabriela; Sheffield, Kristin M.; Parmar, Abhishek D.; Han, Yimei; Brown, Kimberly M.; Riall, Taylor S.

doi:10.1016/j.surg.2013.04.013

Cited by 22 publications

(21 citation statements)

References 32 publications

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“…Race, age and marital status had no effect. Vargas and colleagues 32 found that among 12,381 patients from the Texas Cancer Registry who were recurrence free for 3 years, 75.3% received at least one colonoscopy in a 3-year surveillance period. Salloum and colleagues 33 found that among 2297 patients, only 55.0% received one complete exam of the colon during the 18 months after treatment with curative intent.…”

Section: Discussionmentioning

confidence: 99%

Adherence to colonoscopy at 1 year following resection of localized colon cancer: a retrospective cohort study

Neugut

Zhong

Lebwohl

et al. 2018

Therap Adv Gastroenterol

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Background: For patients with stages I-III colon cancer who have undergone surgical resection, guidelines recommend surveillance colonoscopy at 1 year. However, limited data exist on adherence and associated factors. We aimed to determine the rate of adherence to surveillance colonoscopy at 1 year among nonmetastatic colon cancer patients who underwent resection and factors associated with adherence. Methods: In this population-based retrospective cohort study, the Surveillance, Epidemiology, and End Results (SEER)-Medicare database was used. We identified patients with stages I-III colon cancer who underwent surgical resection and survived >3 years without recurrence (no chemotherapy after 8 months) from 2002-2011. Our primary outcome was a colonoscopy claim 10-15 months after resection. We used multivariable regression analysis to assess associations between sociodemographic and clinical factors and receipt of timely colonoscopy. Results: Among 28,732 patients who survived >3 years without recurrence, 7967 (28%) did not undergo colonoscopy; 12,033 (42%) had it at one year, with 3159 (11%) before 10 months and 5573 (19%) after 15 months. Decreased adherence was associated with older age; being male versus female; being black or Hispanic versus white; higher tumor stage; left-sided tumors versus right sided; and increased comorbidities. Chemotherapy receipt was associated with increased adherence (odds ratio 2.06; 95% confidence interval 1.88-2.24). Conclusions:In a large population-based sample of individuals aged ⩾ 65 years, only 42% of colon cancer survivors underwent 1-year surveillance colonoscopy. Demographic and clinical factors were associated with adherence.

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Section: Discussionmentioning

confidence: 99%

Adherence to colonoscopy at 1 year following resection of localized colon cancer: a retrospective cohort study

Neugut

Zhong

Lebwohl

et al. 2018

Therap Adv Gastroenterol

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“…Specialist care may improve guideline adherence, but the increased use of tests is perhaps a function of differential access to health care resources. 21,22 In our study, Ͼ 80% of the patients who had visited a medical oncologist after surgery had undergone a PET scan, and these patients were more likely to have undergone an early postsurgery scan. Also, patients who had visited a medical oncologist postsurgery and had received chemotherapy were greater than six times more likely to have undergone a PET scan compared with patients who had not visited a medical oncologist postsurgery or received chemotherapy.…”

mentioning

confidence: 61%

“…It is possible that advanced imaging studies performed within 6 months after surgery were done so for postoperative complications rather than for surveillance. 20,21 However, there is no role for PET in evaluating postoperative complications. Although these early PET scans could have been performed to establish a postsurgical baseline, there is no established role for early postoperative imaging in the routine care of patients with CRC who had been preoperatively staged.…”

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confidence: 99%

Variation in Positron Emission Tomography Use After Colon Cancer Resection

Bailey

You

et al. 2015

JOP

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Purpose: Colon cancer surveillance guidelines do not routinely include positron emission tomography (PET) imaging; however, its use after surgical resection has been increasing. We evaluated the secular patterns of PET use after surgical resection of colon cancer among elderly patients and identified factors associated with its increasing use. Patients and Methods:We used the SEER-linked Medicare database (July 2001 through December 2009) to establish a retrospective cohort of patients age Ն 66 years who had undergone surgical resection for colon cancer. Postoperative PET use was assessed with the test for trends. Patient, tumor, and treatment characteristics were analyzed using univariable and multivariable logistic regression analyses.Results: Of the 39,221 patients with colon cancer, 6,326 (16.1%) had undergone a PET scan within 2 years after surgery. The use rate steadily increased over time. The majority of PET scans had been performed within 2 months after surgery. Among patients who had undergone a PET scan, 3,644 (57.6%) had also undergone preoperative imaging, and 1,977 (54.3%) of these patients had undergone reimaging with PET within 2 months after surgery. Marriage, year of diagnosis, tumor stage, preoperative imaging, postoperative visit to a medical oncologist, and adjuvant chemotherapy were significantly associated with increased PET use. Conclusion:PET use after colon cancer resection is steadily increasing, and further study is needed to understand the clinical value and effectiveness of PET scans and the reasons for this departure from guideline-concordant care.

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“…CEA is a tumor marker especially overexpressed in colorectal cancer, and there are many contradictory findings about sensitivity and usefulness of this tumor marker. It must be consider that assessment of CEA levels in serum has a major role in following and monitoring of patients for relapse after intended therapeutic program of CRC [8,10]. But there are several reports about unspecific elevated levels of CEA in apparently healthy smokers and elderly individuals or in some benign conditions such as liver and gastrointestinal system inflammations of any cause.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Serum Carcinoembryonic Antigen in Patients with Newly Diagnosed Colorectal Cancer and Healthy Individuals

Younesi¹

2016

Ann Clin Lab Res

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Aims: Studies have shown that serum levels of tumor markers are influenced by several factors. The present study has assessed the effect of smoking, age, sex and on elevated levels of carcinoembryonic antigen (CEA) among the healthy individuals, and has compared it in patients with newly diagnosed colorectal cancer. Methods:Our experimental study was conducted on 800 cases in Iran. We had two parallel groups including 675 normal cases and 125 patients with colorectal cancer. The quantitative measurement of CEA for the recruited individuals was carried out by RIA method. Results:We observed the distribution of CEA values was significantly higher in colorectal cases than apparently healthy cases (P<0.001). Also the distribution of CEA values was found to be significantly higher in the healthy smokers group when compared to the healthy nonsmokers (P<0.05). Comparison among mean of CEA levels in three age groups including individuals with mean age under 30 years, between 30 and 60 years and upper 60 years old respectively as groups 1, 2 and 3 showed significantly elevated CEA levels in over 60 years individuals (P<0.05).Conclusions: This study indicated that among all disagreements about CEA validity as a beneficial tool for clinicians, they should be aware of the usefulness of the CEA level in serum but even a very high CEA level should not be considered by itself as evidence of cancer.

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Physician follow-up and observation of guidelines in the post treatment surveillance of colorectal cancer

Cited by 22 publications

References 32 publications

Adherence to colonoscopy at 1 year following resection of localized colon cancer: a retrospective cohort study

Adherence to colonoscopy at 1 year following resection of localized colon cancer: a retrospective cohort study

Variation in Positron Emission Tomography Use After Colon Cancer Resection

A Prospective Study of Serum Carcinoembryonic Antigen in Patients with Newly Diagnosed Colorectal Cancer and Healthy Individuals

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