Report in English with a Dutch summary (KCE reports 45A)
Report in English with a Dutch summary (KCE reports 45A)
Report in English with a Dutch summary (KCE reports 45A)
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178 Screen<strong>in</strong>g for Colorectal Cancer: Appendices <strong>KCE</strong> <strong>reports</strong> vol.45<br />
4 Guidel<strong>in</strong>es for<br />
colonoscopy surveillance<br />
after cancer resection: a<br />
Consensus Update 69.<br />
US Multi-Society Task<br />
Force on Colorectal<br />
Cancer and the<br />
American Cancer<br />
Society<br />
2006 Not <strong>in</strong>cluded Not <strong>in</strong>cluded 1. Patients <strong>with</strong> colon and<br />
rectal cancer should undergo<br />
high quality perioperative<br />
clear<strong>in</strong>g. In the case of<br />
nonobstruct<strong>in</strong>g tumors, this<br />
can be done by preoperative<br />
colonoscopy. In the case of<br />
obstruct<strong>in</strong>g colon cancers,<br />
computed tomography<br />
colonography <strong>with</strong><br />
<strong>in</strong>travenous contrast or<br />
double contrast barium<br />
enema can be used to detect<br />
neoplasms <strong>in</strong> the proximal<br />
colon. In these cases, a<br />
colonoscopy to clear the<br />
colon of synchronous<br />
disease should be considered<br />
3 to 6 months after the<br />
resection if no unresectable<br />
metastases are found dur<strong>in</strong>g<br />
surgery. Alternatively,<br />
colonoscopy can be<br />
performed <strong>in</strong>traoperatively.<br />
2. Patients undergo<strong>in</strong>g<br />
curative resection for colon<br />
or rectal cancer should<br />
undergo a colonoscopy 1<br />
year after the resection (or<br />
1 year follow<strong>in</strong>g the<br />
performance of the<br />
colonoscopy that was<br />
performed to clear the<br />
colon of synchronous<br />
disease). This colonoscopy at<br />
1 year is <strong>in</strong> addition to the<br />
perioperative colonoscopy<br />
for synchronous tumors.<br />
3. If the exam<strong>in</strong>ation<br />
performed at 1 year is<br />
normal, then the <strong>in</strong>terval<br />
before the next subsequent<br />
exam<strong>in</strong>ation should be 3<br />
years. If that colonoscopy is<br />
normal, then the <strong>in</strong>terval<br />
before the next subsequent<br />
exam<strong>in</strong>ation should be 5<br />
years.<br />
4. Follow<strong>in</strong>g the exam<strong>in</strong>ation<br />
at 1 year, the <strong>in</strong>tervals<br />
before subsequent<br />
exam<strong>in</strong>ations may be<br />
shortened if there is<br />
evidence of hereditary<br />
nonpolyposis colorectal<br />
cancer or if adenoma<br />
f<strong>in</strong>d<strong>in</strong>gs warrant earlier<br />
colonoscopy.<br />
5. Periodic exam<strong>in</strong>ation of<br />
the rectum for the purpose<br />
of identify<strong>in</strong>g local<br />
recurrence, usually<br />
Not <strong>in</strong>cluded Not <strong>in</strong>cluded Not <strong>in</strong>cluded