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  • Annual colonoscopy, chest radiography, and computed tomography of the liver did not prolong survival in patients with colorectal cancer

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CLINICAL ALERT
Annual colonoscopy, chest radiography, and computed tomography of the liver did not prolong survival in patients with colorectal cancer
  1. P FAIRCLOUGH
  1. B HAYNES
  1. Department of Gastroenterology,
  2. Royal Hospitals NHS Trust,
  3. London, UK
  4. Health Information Research Unit,
  5. Department of Clinical Epidemiology and Biostatistics,
  6. McMaster University, Hamilton, Ontario, Canada

https://doi.org/10.1136/gut.43.3.314

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    Does the addition of annual computed tomography (CT) scanning, chest x ray and colonoscopy to standard clinical follow up improve outcome in unselected patients with colorectal cancer? Sadly, the answer seems to be “no”. This study and that of Makela and coworkers1 show no benefit in intensive follow up, and that of Ohlsson and colleagues2showed no benefit in follow up at all.

    Tumour stage and adherence to adjacent structures influenced survival, but when these were corrected for, and despite a 90% power to detect a 15% difference at p<0.05, the 5-year survival rate was not affected by intensive follow up. There was a 9% absolute increment in 5-year survival in the intensive group, but at least 600 patients in each group would be needed to show whether this is real. Briefly, the benefit of the 633 chest x rays in those screened yearly was a single patient who survived 5 years. Annual colonoscopy showed only one …

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    Footnotes

    • Sources of funding: Anti-Cancer Foundation of the Universities of South Australia and the Commonwealth Health and Medical Research Council of the Department of Veteran’s Affairs.

    • For article reprint: Dr J Toouli, Gastrointestinal Surgical Unit, Flinders Medical Centre, Bedford Park, Adelaide, South Australia 5042, Australia. Fax +61 8 8204 5966.