NCCN guidelines were accessed on 1/28/12. There were minor quantitative and qualitative changes compared to the guidelines accessed on 4/10/07

^aThe numbers in the table indicate the number of times the modality is recommended during the indicated year post-treatment

^bFor T2 or greater lesions

^cIf patient is a potential candidate for resection of isolated metastasis

^dFor patients at high risk for recurrence (e.g., lymphatic or venous invasion by tumor, or poorly differentiated tumors)

^eColonoscopy in 1 year except if no preoperative colonoscopy due to obstructing lesion, colonoscopy in 3–6 months. If advanced adenoma (villous polyp, polyp >1 cm, or high grade dysplasia), repeat in 1 year. If no advanced adenoma, repeat in 3 years, then every 5 years

^fFor patients status post low anterior resection of the rectum

^gPatients with rectal cancer should also undergo limited endoscopic evaluation of the rectal anastomosis to identify local recurrence. Optimal timing for surveillance in not known. No specific data clearly support rigid versus flexible proctoscopy. The utility of routine endoscopic ultrasound for early surveillance is not defined

ASCO guidelines were accessed on 1/28/12. There were no significant changes compared to the guidelines accessed on 10/31/07

^aThe numbers in the table indicate the number of times the modality is recommended during the indicated year post-treatment

^bPhysician visit after 5 years at the discretion of the physician

^cFor patients with stage II or III disease if the patient is a candidate for surgery or systemic therapy

^dSince fluorouracil-based therapy may falsely elevate CEA values, waiting until adjuvant treatment is finished to initiate surveillance is advised

^eFor patients who are at a higher risk or recurrence, and who could be candidates for curative-intent surgery. A pelvic CT scan should be considered for rectal cancer surveillance, especially for patients who have not been treated with radiotherapy

^fAll patients with colon and rectal cancer should have a colonoscopy for pre- and perioperative documentation of a cancer- and polyp-free colon. If normal at 3 years, once every 5 years thereafter

^gFor colorectal cancer patients with high-risk genetic syndromes, the physician should consider the guideline published by the American Gastroenterology Association

^hFor rectal cancer patients who have not received pelvic radiation

ESMO guidelines were accessed on 1/28/12. There were minor quantitative and qualitative changes compared to the guidelines accessed on 10/31/07

^aThe numbers in the table indicate the number of times the modality is recommended during the indicated year post-treatment

^bA completion colonoscopy, if not done at the time of diagnostic work-up (e.g. if obstruction was present), should be performed within the first year. History and colonoscopy with resection of colonic polyps every 5 years