Postoperative Surveillance Adherence in Colorectal Cancer Patients at Urban Medical Centers: Is It Adequate?

Introduction Colorectal cancer (CRC) is among the most frequent cancers in the United States. There are recognized guidelines for monitoring after curative CRC excision. This study looks into the rate of compliance with surveillance guidelines following CRC resection, as well as the impact of demographic characteristics. Methods Data was collected retrospectively including demographics, stage at diagnosis, and adherence to surveillance guidelines as recommended by the United States Multi-Society Task Force (USMSTF) guidelines for CRC patients who underwent curative surgical resection between 2005 and 2014 in two tertiary academic medical centers. Results A total of 124 patients were included (male, 56.5%; female, 43.5%), 109 (87.9%) were African Americans, and 70 (56.5%) had Medicare/Medicaid insurance. Overall, appropriate clinical evaluation twice per year for three years following surgery was completed in 78 patients (63%). A total of 56 patients (45%) had carcinoembryonic antigen (CEA) levels checked twice a year for three years. Surveillance colonoscopy one year postoperatively occurred in 64 (51.6%), and 37 (29.8%) had a second colonoscopy three years postoperatively. Abdomen/pelvis CT scan was obtained in 90 (72.5%) at one year postoperatively. In the entire cohort, strict adherence to post-resection surveillance only occurred in 46 (37.1%). There was no correlation between adherence to surveillance and gender (p=0.184), race (p=0.118), or insurance type (p=0.51). Conclusion Adherence to surveillance after curative CRC resection was inadequate regardless of socioeconomic status, medical insurance, or race. Measures should be taken to identify barriers and improve compliance with guidelines.