How do gastroenterologists follow patients with colorectal cancer after curative surgical resection? A three-year population-based study

Objectives - To assess the contribution of gastroenterologists (GEs) to the surveillance of colorectal cancer after curative surgery. Patients and methods - This registry-based study included 407 patients residing in two French administrative areas diagnosed with newly diagnosed colorectal cancer in 1998 and free of disease six months after curative surgery. All surveillance examinations performed either in the three years after surgery or until death or recurrence were collected retrospectively. Results - One hundred nine patients (27%) had a regular clinical check-up with a GE at least once a year. Factors independently associated with GE follow-up were young age (P=0.004), use of adjuvant chemotherapy (P=0.013), and surgeon follow-up (P=0.068). GEs ordered 84% of colonoscopies, 44% of abdominal ultrasound examinations and 52% of abdominal CT scans. They detected 35% of recurrences. A significant proportion of patients (20%) had no regular follow-up, irrespective of the physicians involved. Conclusions - GEs play a modest role in the routine follow-up of patients with colorectal cancer, but are largely involved in ordering surveillance tests. They might play an important role in the surveillance of patients who presently have poor access to health care.