Published online Feb 28, 2014. doi: 10.3748/wjg.v20.i8.1887
Revised: November 27, 2013
Accepted: January 3, 2014
Published online: February 28, 2014
Processing time: 147 Days and 8.7 Hours
The accumulated evidence from two decades of randomized controlled trials has not yet resolved the question of how best to monitor colorectal cancer (CRC) survivors for early detection of recurrent and metachronous disease or even whether doing so has its intended effect. A new wave of trial data in the coming years and an evolving knowledge of relevant biomarkers may bring us closer to understanding what surveillance strategies are most effective for a given subset of patients. To best apply these insights, a number of important research questions need to be addressed, and new decision making tools must be developed. In this review, we summarize available randomized controlled trial evidence comparing alternative surveillance testing strategies, describe ongoing trials in the area, and compare professional society recommendations for surveillance. In addition, we discuss innovations relevant to CRC surveillance and outline a research agenda which will inform a more risk-stratified and personalized approach to follow-up.
Core tip: We summarize the current state of knowledge and recommended practice around post-treatment surveillance of colorectal cancer survivors. In addition, we describe relevant ongoing trials and the questions which they will and will not answer regarding best surveillance practices. With that background as context, we discuss related practice innovations and propose a number of research questions whose answers could inform more effective, personalized approaches to surveillance.