237 Background: The 2005 ASCO surveillance guidelines for Stage II/III colon cancer recommended chest, abdomen (and pelvis) imaging annually for 3 years, checking a CEA every 3 months for the first 3 years and colonoscopy 1 year after surgery or preoperatively. Our primary aim was to determine Mount Sinai Hospital’s (MSH) compliance rate with ASCO surveillance guidelines, with a goal of achieving 80% compliance. We hypothesized a bias to over-imaging. A secondary aim was to determine the frequency at which high risk Stage II patients were referred to medical oncology. Methods: A retrospective study of 118 patients with newly diagnosed stage II or III colon cancer at MSH in 2011 and 2012 was undertaken. Results: Compliance rates for early surveillance measures included. 1. Checking CEA approximately every 3 months: Stage II - 84%; Stage III - 88%. 2. Colonoscopy guidelines: Stage II - 72% and Stage III - 94%. Imaging post surgery or adjuvant treatment: Stage II - 48% and Stage III - 70%. Subsequent imaging: Stage II - 44%; Stage III - 28%. (See Table.) Overall compliance with early surveillance guidelines was 55% for Stage II patients and 83% for Stage III patients. All of the non-compliance for subsequent imaging was due to overscanning. Only 62% of high risk Stage II patients were referred to medical oncology. Conclusions: Our baseline compliance to early surveillance measures for colon cancer did not consistently achieve our pre-specified benchmark. Specific areas of improvement include avoidance of overscanning during colon cancer surveillance after adjuvant chemotherapy and an improved rate of referral of high risk Stage II patients to medical oncology after surgery. [Table: see text]
Cost-effectiveness and quality of life in surgeon versus general practitioner-organised colon cancer surveillance: a randomised controlled trial
