Recurrence statistics for Stage III Colon Cancer

Last Modified: April 10, 2005

Question:

Dear OncoLink "Ask The Experts,"
I am vast approaching my three year surgical resection anniversary. I was Stage III colon cancer with 1 out of 23 nodes tested positive (40 years old) Colon resection with all normal margins. (1 ½ inches of rectum removed 5-FU and Radiation. My health has been very good. All Scans clear for three years.
What the normal testing protocol after three years? I am always concerned about recurrence. After three years from surgery are the statistics get better?

Answer:

Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and Rectal Surgery, responds:

After two years, the recurrence statistics start to improve dramatically, although we are fairly vigilant up to 5 years after diagnosis and treatment.

Proper follow-up is difficult to get a consensus across the board. However, it should include a colonoscopy at year 1 after surgery, and another one 3 years later. Colonoscopy 3 years after that is probably wise, and if that is negative, again 5 years later. CT scans could probably be reduced to once a year until year 5 with CEA's twice a year.

The vigilance of colonoscopic evaluation is partly based on estimated risk. If you are quite young, (less than 50) at diagnosis or have a strong family history (3 first degree relatives with colon cancer) in two successive generations, then you may have a hereditary form of cancer and may need more frequent screening. These patients or patients who feel they may benefit from genetic counseling can get a much better idea of their risk based on a detailed evaluation of family history. Anybody can take advantage of the service.

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