SURGEONS FOLLOW-UP PRACTICE AFTER RESECTION OF COLORECTAL-CANCER

Consultant surgeons in two United Kingdom Health Regions were invited to complete a questionnaire on details of their personal management of patients with colon and rectal cancer, with particular emphasis on fo llow-up. Replies from 140 (94%) were analysed by the surgeon's subspec ialty of colorectal and gastrointestinal surgery (group I) and all oth ers (group 2). There was a wide variation in the duration of followup, but no difference between the two groups. More group 1 surgeons carri ed out investigations as a routine after colonic (P < 0.01) and rectal (P < 0.01) resection. Colonoscopy was used more frequently by group 1 (P < 0.0001) and barium enema by group 2 surgeons (P < 0.05). Investi gations to detect asymptomatic metastases were used as a routine by 33 .3% of surgeons, in whom there was no concordance over the choice or c ombination of tests and no difference between the two groups of surgeo ns. There is no consensus among surgeons as to the ideal duration, int ensity and method of follow-up after resection for colorectal cancer a nd little difference between the practice of colorectal and gastrointe stinal surgeons and that of other specialists, except in the use of co lonoscopy and barium enema. These results reflect the continuing lack of evidence on which to base the follow-up of patients after surgery f or colorectal cancer.