Postoperative Surveillance Adherence in Colorectal Cancer Patients at Urban Medical Center: is it Adequate?

Abstract

AbstractAimTo examine the adherence rate to surveillance guidelines after curative resection of colorectal cancer (CRC) and the impact of demographic factors.MethodsData was collected retrospectively including demographics, stage at diagnosis, and adherence to surveillance guidelines as recommended by the US Multi-Society Task Force (USMSTF) guidelines, for colorectal cancer (CRC) patients who underwent curative surgical resection between 2005 and 2014 in a tertiary academic medical center.ResultsA total of 124 patients were included (Male /female, 56.5%/ 43.5%), African American 109 (87.9%), and 70 patients (56.5%) had Medicare/Medicaid insurance. Overall, Appropriate clinical evaluation twice per year for 3 years following surgery was completed in 78 (63%) of patients. A total of 56 (45%) had carcinoembryonic antigen (CEA) levels checked twice a year for 3 years. Surveillance colonoscopy 1 year postoperatively occurred in 64 (51.6%), and 37 (29.8%) had a second colonoscopy 3 years postoperatively. Abdomen/pelvis CT scan was obtained in 90 (72.5%) at 1 year post-operatively. In the entire cohort, strict adherence to post-recession 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).ConclusionAdherence to surveillance after curative resection of CRC was inadequate regardless of socioeconomic, medical insurance, or race. Measures should be taken to identify barriers and improve compliance with guidelines.What is already known on this topic?Effective surveillance after colorectal cancer surgery is essential, yet many patients fail to follow recommended guidelines. Existing research highlights disparities in CRC outcomes based on race, socioeconomic status, and insurance coverage, affecting early detection and treatment.What this study addsOur study reveals a 37.1% adherence rate to surveillance guidelines among CRC patients in an urban medical center, unaffected by gender, race, or insurance status. This challenges previous assumptions about demographic disparities in post-resection care.How this study might affect research, practice, or policyThe study highlights the need for interventions to improve adherence rate to CRC surveillance. Future research, clinical practices, and policy initiatives should focus on overcoming barriers to ensure equitable and effective follow-up care.