Sammanfattning
BACKGROUND : Colorectal cancer is one of the most frequent cancers in the Western world. Systematic surveillance after curative resection is common practice in Norway. The article presents the scientific grounds for surveillance in general, and for the Norwegian guidelines in particular.
MATERIAL AND METHOD : The basis for the study is literature on updated meta-analyses, randomized studies and reviews from 2002 to April 2007 (retrieved from Medline), and an evaluation of own experience with the national guidelines for follow-up.
RESULTS AND INTERPRETATION : Meta-analyses indicate better overall survival with systematic surveillance after curative resection for colorectal cancer, but the scientific evidence remains uncertain. Clinical practice varies from the setup in randomized trials and direct comparison is difficult. The exact factors associated with better survival remain unclear. The Norwegian surveillance routines contribute to diagnosing about 10 % of all patients with recurrent disease while they are still asymptomatic and amenable to secondary curative surgery. Systematic surveillance after curative resection for colorectal cancer is time-consuming and costly, and secondary curative surgery is only possible in a small proportion of the patients. Realistic and adequate information on what the surveillance can offer is an important part of optimal care. Several large ongoing international studies will shed new light on the usefulness of systematic surveillance.