10
Treatment
Table 10. Early-Stage Rectal Cancer Post-Treatment
Surveillance
Population Intervention Setting
Treated patients with
rectal cancer
Medical history, physical exam every 6 months
for minimum 3 years. CEA every 6 months for
minimum of 3 years if available. Chest x-ray and
abdominal and pelvic ultrasound twice in the
first 3 years. Rectosigmoidoscopy or colonoscopy,
(if colonoscopy available in local or referral
setting ), once in the first 1–2 years aer surgery.
(Moderate Recommendation; I)
Basic
Treated patients
with rectal cancer at
standard risk
Medical history, physical exam and CEA every
6 months for 3–5 years. CT scan of the chest,
abdomen and pelvis twice in the first 3 years.
Colonoscopy 1 year aer surgery then every 5
years or earlier as clinically indicated up to 75
years of age (if colonoscopy available in local
or referral setting ).
a
(For Enhanced, for those
patients who have not received pelvic radiation)
(Moderate Recommendation; I)
Limited,
Enhanced,
and
Maximal
Treated patients with
rectal cancer at high
risk
Medical history, physical exam and CEA every
3–6 months for 5 years. CT scan of the chest,
abdomen and pelvis 6–12 months for 3 years.
Colonoscopy 1 year aer surgery then every 5
years or earlier as clinically indicated up to 75
years of age.
a
(Moderate Recommendation; I)
Enhanced
and
Maximal
Treated patients with
rectal cancer who have
not received pelvic
radiation or who
underwent surgery
without TME or who
have had a positive
circumferential
resection margin
Digital rectal exam or rectosigmoidoscopy may
be performed every 6 months for 3 years based
on availability. (Weak Recommendation; L)
Basic
Treated patients
with rectal cancer at
standard risk who have
not received pelvic
radiation or who
underwent surgery
without TME or who
have had a positive
circumferential
resection margin
Digital rectal exam or rectosigmoidoscopy should
be performed every 6 months for 3 years based
on availability.
a
(Moderate Recommendation; I)
Limited
