The decision to treat patients with recurrent colorectal cancer

Although universally performed, postoperative diagnostic screening in patients with colorectal cancer has not been demonstrated to diminish overall mortality. Such screening often leads to second-look surgery, with many anecdotal successes but again no evidence that overall mortality is reduced. The cost of such interventions is at least $1 billion dollars per year in the United States and may be twice that amount. The research that is needed to support postoperative screening and surgery is feasible and economically easily justified. The endpoints must be shifted from that of previous studies, which have focused on sensitivity of screening techniques, to mortality. Such a study is ongoing in Denmark, and early results of that study should be reported soon.