Table 3 Description of randomized trials of follow-up of colorectal cancer after resection.

Makela [36]

Finland (1988–90)

Regular (n = 54): Clinical assessment, blood counts and CEA, chest x-ray, and fecal occult blood (FOB) every 3 months for 2 years, then every 6 months for next 3 years; rigid sigmoidoscopy for rectosigmoid tumours at each visit, and yearly barium enema for all patients.

Intensive (n = 52): Clinical assessment, blood counts and CEA, chest x-ray and FOB as in regular follow-up program. In addition, colonoscopy at 3 months if not performed preoperatively and then yearly thereafter on all patients, flexible sigmoidoscopy for rectosigmoid tumors every 3 months, liver ultrasound every 6 months, and yearly CT of liver and site of operation.

Ohlsson [37]

Sweden (1983–86)

Minimal (n = 54): FOB every 3 months for 2 years, then yearly, and to consult for a list of symptoms.

Regular (n = 53): Clinical assessments, blood CEA and liver enzyme, chest x-ray, FOB and rigid sigmoidoscopy every 3 months for 2 years, then every 6 months; endoscopy control of anastomosis by flexible endoscopy at 9, 21, and 42 months; complete colonoscopy at 3, 15, 30, and 60 months; CT of pelvis (if they had abdominoperineal resection) at 3,6,12, 18, and 24 months.

Kjeldsen [38]

Denmark (1985–94)

Minimal (n = 307): Clinical assessment, blood hemoglobin, sedimentation rate and liver enzymes, chest x-ray, FOB, and colonoscopy (if incomplete, double contrast barium enema) at 5, 10, and 15 years.

Regular (n = 290): Same tests as minimal follow-up program, but tests were conducted every 6 months for 3 years, and then at 4, 5, 7.5, 10, 12.5, and 15 years.

Schoemaker [39]

Australia (1984–90)

Minimal (n = 158): Clinical assessment, blood counts, CEA, liver function tests and FOB every 3 months for 2 years, then every 6 months for 5 years; chest x-rays, liver CT scan and colonoscopy at 5 years.

Regular (n = 167): Clinical assessment, blood counts, CEA, liver function tests and FOB as in regular follow-up program. In addition, chest x-rays, liver CT scan and colonoscopy annually. Isolated increase in CEA levels did not trigger further investigations.

Pietra [40]

Italy (1987–90)

Regular (n = 103) Clinical assessment, CEA, and liver ultrasound every 6 months for one year, then yearly; chest x-ray and colonoscopy yearly.

Intensive (n = 104) Clinical assessment, CEA, and liver ultrasound as regular follow-up program, but tests conducted every 3 months for 2 years, then every 6 months for 3 years, and yearly thereafter. In addition, chest x-ray, abdominal CT and colonoscopy yearly.

Secco [41]

Italy (1988–96)

Minimal (n = 145) Patients to phone the surgical team every 6 months. Clinical assessment by family physician at least once a year or when suggestive symptoms of recurrence occurred.

Intensive (n= 192) High Risk Patients: Clinical assessment and CEA every 3 months for 2 years, every 4 months in the third year and every 6 months in years 4 and 5. Abdominal and pelvic ultrasound performed every 6 months the first 3 years and yearly in years 4 and 5. Rigid recto-sigmoidoscopy and chest x-ray yearly for patients with rectal cancer. Low Risk Patients: Clinical assessment and CEA every 6 months for 2 years, then yearly; abdominal and pelvic ultrasound every 6 months for 2 years, then once a year. Rigid recto-sigmoidoscopy for rectal cancer yearly twice, then every 2 years and chest x-ray yearly.