CRC: ESGE, ESDO issue guidelines for postresection colonoscopy

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Takeaway

  • The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Digestive Oncology (ESDO) have issued guidelines for endoscopic surveillance of patients with colorectal cancer (CRC) after surgical or endoscopic resection.

Why this matters

  • These guidelines can help ensure optimal use of limited endoscopy resources.

Key points

  • Patients should undergo postsurgical endoscopic surveillance after intent-to-cure surgery and oncological treatment. (Strong recommendation based on low-quality evidence)
  • Patients should undergo colonoscopy within 6 months of surgery. (Strong recommendation, low-quality evidence)
  • Patients should undergo colonoscopy 1 year after surgery. (Strong recommendation, moderate-quality evidence)
  • Intensive surveillance strategies, such as annual colonoscopies, have not been proven to be of benefit and are not recommended. (Strong recommendation, moderate-quality evidence)
  • Additional surveillance colonoscopies should be performed at 3 years and 5 years after initial surveillance colonoscopy. Shorter intervals should be considered if surveillance colonoscopies reveal high-risk neoplastic lesions. (Weak recommendation, low-quality evidence)
  • After the first surveillance colonoscopy, postsurgical colonoscopies can be stopped at age 80 years or earlier if comorbidities are expected to reduce life expectancy. (Weak recommendation, low-quality evidence)
  • This recommended endoscopic surveillance schedule also applies to patients with a low-risk pT1 CRC treated by endoscopy with an R0 resection.