Colonoscopy recommended at 1, 6, and 11 years after colon cancer resection.
If colonoscopies performed at 1, 6 and 11 years post resection are normal:
If colonoscopy reveals adenoma:
If incomplete colonoscopy pre-op:
If age ≥ 75 years:
More frequent colonoscopy is indicated in the following groups:
Other surveillance:
Clinical review 3-6 monthly for one year, 6-monthly for two years, then yearly for a total of 5 years.
CEA measurement at each consultation
Annual CT chest / abdo / pelvis
If colonoscopies performed at 1, 6 and 11 years post resection are normal:
- iFOBT every 2 years, or
- colonoscopy at 10 years (21 years post resection)
If colonoscopy reveals adenoma:
- next colonoscopy guided by polyp features
- If subsequent colonoscopy is normal, back to cancer surveillance (6 and 11 years after resection)
If incomplete colonoscopy pre-op:
- semi-urgent colonoscopy when feasible (within 6 months)
If age ≥ 75 years:
- surveillance based on age and comorbidity
More frequent colonoscopy is indicated in the following groups:
- Hereditary colorectal cancer syndromes (identified or suspected, see full guidelines)
- Initial diagnosis younger than 40 years
- Have multiple synchronous cancers or additional advanced adenomas at initial diagnosis
Other surveillance:
Clinical review 3-6 monthly for one year, 6-monthly for two years, then yearly for a total of 5 years.
CEA measurement at each consultation
Annual CT chest / abdo / pelvis