Optimal follow-up in colorectal cancer patients: what tests and how often?

Patients' benefit from follow-up examinations after curative surgery for colorectal cancer is unproven in spite of numerous different programs' having been designed for that purpose. Unfortunately, no final results from prospective randomized studies have been published yet and no ideal marker for recurrent cancer is available to identify patients in whom new curative treatment may be possible. So far, screening for metachronous neoplasia with intervals of several years may influence survival, whereas benefit from detecting recurrent colorectal cancer may be claimed only by using historical or other inappropriate controls. The tradition of follow-up is expensive and prospective evidence for any cost benefit is needed to justify continuous use of our limited resources in this area of patient care.