Scandinavian surveillance follow-up programmes in patients with malignant colorectal polyps

INTRODUCTION: Following endoscopic removal of malignant colorectal polyps, patients may undergo completion radical resection or surveillance. The optimal surveillance strategy remains unknown. This study included colorectal departments in Scandinavian countries with a focus on follow-up periods and examination modalities for patients with endoscopically removed malignant polyps with a resection margin > 1 mm.

METHODS: This study was conducted as an internet-based survey. A questionnaire was sent to all Scandinavian surgical departments performing > 20 colorectal procedures annually. Questions differed between follow-up on rectal and colonic malignant polyps with presence or absence of histological risk factors. The follow-up period was defined as short (one year), intermediate (three years) or long (five years).

RESULTS: The majority of the departments used a long (five years) (38-59%) or intermediate (three years) (26-38%) follow-up programme. In patients with rectal malignant polyps and presence of histological risk factors, a significant difference was observed in the use of endoscopy according to length of follow-up. No difference in the use of the different modalities was seen according to length of follow-up in patients with colonic malignant polyps.

CONCLUSIONS: The follow-up on patients with endoscopically removed malignant polyps and a surveillance strategy varies both in terms of length and performed modalities. Future studies should compare long-term patient outcomes in departments employing different follow-up strategies.

FUNDING: none.

TRIAL REGISTRATION: not relevant.