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World J Gastrointest Oncol. 2014 May 15;6(5):104-11. doi: 10.4251/wjgo.v6.i5.104.

Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review.

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  • 1Knut Magne Augestad, Benjamin Crawshaw, Conor Delaney, Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106, United States.


Most patients treated with curative intent for colorectal cancer (CRC) are included in a follow-up program involving periodic evaluations. The survival benefits of a follow-up program are well delineated, and previous meta-analyses have suggested an overall survival improvement of 5%-10% by intensive follow-up. However, in a recent randomized trial, there was no survival benefit when a minimal vs an intensive follow-up program was compared. Less is known about the potential side effects of follow-up. Well-known side effects of preventive programs are those of somatic complications caused by testing, negative psychological consequences of follow-up itself, and the downstream impact of false positive or false negative tests. Accordingly, the potential survival benefits of CRC follow-up must be weighed against these potential negatives. The present review compares the benefits and side effects of CRC follow-up, and we propose future areas for research.


Cancer survivorship; Colorectal cancer; False positive; Follow-up; Surveillance

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