THE PATTERN OF RECURRENT COLORECTAL-CANCER IN A PROSPECTIVE RANDOMIZED STUDY AND THE CHARACTERISTICS OF DIAGNOSTIC-TESTS

In a prospective randomised study, 597 patients subjected to curative surgery for colorectal cancer were allocated to either a group with fr equent follow-up or a control group with follow-up every 5 years. The pattern of recurrence is reviewed. An equal number of recurrences was detected in the two groups, but the recurrence was diagnosed 9 months earlier in patients followed frequently, and the diagnostic characteri stics of various tests dependent upon how often they were used. It is unlikely that frequent follow-up after curative surgery for colorectal cancer has a large positive influence upon survival, but a small bene fit from an intensive follow-up program cannot be ruled out. The prese nt results indicate that clinical examination, digital rectal examinat ion, proctoscopy, colonoscopy and chest x-ray should be included in su ch a programme, whereas others (blood haemoglobin, faecal occult blood test, double contrast braium enema, serum alanine aminotransferase, a nd serum bilirubin) should be avoided, having a low sensitivity for de tecting recurrent colorectal cancer.