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Surveillance Frequency Doesn’t Cut Mortality in Colorectal Cancer

And, intensity of imaging surveillance not linked to time to detection of colorectal cancer recurrence

TUESDAY, May 22, 2018 (HealthDay News) — For patients with colorectal cancer after curative surgery, the frequency of surveillance is not associated with mortality; and, the intensity of posttreatment surveillance is not associated with detection of recurrence, according to two studies published in the May 22/29 issue of the Journal of the American Medical Association.

Peer Wille-Jørgensen, D.M.Sc., from Bispebjerg Hospital in Copenhagen, Denmark, and colleagues randomized 2,509 patients with stage II or III colorectal cancer after curative surgery to follow-up testing with computed tomography of the thorax and abdomen and serum carcinoembryonic antigen (CEA) at high frequency (1,253 patients) or low frequency (1,256 patients). The researchers found that the five-year overall patient mortality rate was 13.0 and 14.1 percent in the high- and low-frequency groups, respectively (risk difference, 1.1 percent; 95 percent confidence interval, −1.6 to 3.8 percent; P = 0.43).

Rebecca A. Snyder, M.D., M.P.H., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues abstracted data from the medical records of 8,529 patients diagnosed with stage I, II, or III CRC in 2006 to 2007 with follow-up through Dec. 31, 2014. For patients treated at facilities with high-intensity and low-intensity imaging surveillance, the median time to detection of recurrence was 15.1 and 16.0 months, respectively (difference, −0.95 months; 95 percent confidence interval, −2.59 to 0.68 months). The median time to recurrence was 15.9 and 15.3 months for those treated at facilities with high- versus low-intensity CEA testing, respectively (difference, 0.59 months; 95 percent confidence interval, −1.33 to 2.51).

“Among patients treated for stage I, II, or III CRC, there was no significant association between surveillance intensity and detection of recurrence,” Snyder and colleagues write.

One author from each study disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text – Wille-Jørgensen
Abstract/Full Text – Snyder
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