What is appropriate follow-up for the patient with colorectal cancer?

Overall recurrence rates after curative resection for colorectal cancer average 30%. The value of intensive follow-up protocols is assessed from a review of the literature, which reveals that recurrent colorectal cancer can be detected at an earlier stage (average 3 months) and that repeat resection rates for cure can be increased (twofold or more) by intensive follow-up. Despite this, no improvement in survival has been documented. As nonsurgical modalities of therapy for recurrence become further refined, earlier detection of recurrent tumour will become increasingly important. An intensive follow-up regimen is therefore proposed, based on a knowledge of the patterns and timing of recurrence, the relative merits of the investigational modalities available and the assumption that at some point earliest detection and subsequent therapy will improve survival.