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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

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