[Effect of the guidelines for colorectal cancer on clinical practice]

The guidelines for the management of colorectal cancer set out standard treatment policies for this type of cancer. The guidelines were released more than a year ago and have already been so widely adopted that they are used in daily practice by approximately 90% of physicians engaged in the treatment of colorectal cancer. The detailed descriptions related to early cancer in the guidelines are practical, but also tend to standardize various unnecessary surgical treatments. The extent of bowel resection and lymph node dissection is stipulated in detail, but the scientific basis for these requirements needs to be clarified. In addition, because of constant advances in chemotherapy, there should be specific descriptions of the standard therapy available at the present time, and participation in clinical trials should be encouraged. Although there is no standard method of surveillance, the guideline policies are very helpful under the present circumstances. However, there is a need to explore more rational surveillance that take into account cost effectiveness, QOL, and radiation exposure among other factors. The guidelines are a treatment menu that do not cover individualized medical practice, and new treatments cannot be devised by always adhering to the menu.