Don’t order test to detect recurrent cancer in asymptomatic patients if there is not a realistic expectation that early detection of recurrence can improve survival or quality of life.

In some specific situations, the early detection of cancer recurrence (local and/or distant) may increase the likelihood of successful subsequent curative treatment. However, in many circumstances, earlier knowledge of recurrence does not improve outcome. As such, it is important to balance the information that can come from advanced testing with what is best for the individual patient. Specifically, the need for patient reassurance should be balanced against the anxiety and uncertainty provoked by extensive follow-up testing when there is not a realistic expectation that the early identification of recurrence may improve survival or quality of life.

 

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Fahy BN. Follow-up after curative resection of colorectal cancer. Ann Surg Oncol. 2014 Mar;21(3):738-46. PMID: 24271157.

Grunfeld E, et al. Routine follow up of breast cancer in primary care: randomised trial. BMJ. 1996 Sep 14;313(7058):665-9. PMID: 8811760.

Khatcheressian J, et al. Breast cancer follow-up in the adjuvant setting. Curr Oncol Rep. 2008 Jan;10(1):38-46. PMID: 18366959.

Meyerhardt JA, et al. Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American Society of Clinical Oncology clinical practice guideline endorsement. J Clin Oncol. 2013 Dec 10;31(35):4465-70. PMID: 24220554.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colon cancer [Internet]. 2014 [cited 2014 Sep 23].