#11 What other test besides colonoscopy is used for monitoring patients with history of polyps or cancer of colon and rectum ?
Answer : Fecal occult blood test (FOBT)
#12 When do you start using FOBT for follow up surveillance in patients with history of colorectal polyps or cancers ?
10 years after the last colonoscopy for patients with hyperplastic polyp
Other groups of patients should not be followed with FOBT.
#13 What other services are available for individuals with family history of HNPCC or FAP
#14 What is the goal of follow-up after resection of the cancer of colon and rectum ?
Identify of recurrent disease
Identification of metastases
Identification of subsequent adenomas
#15 Which category of patients are not usually recommended routine surveillance for cancer of colon and rectum ?
Patients who are advanced in age
Patients who have significant co-morbidities
Patients with limited 5 year life expectancy
#16 What is the post operative follow up schedule for patients with cancer of colon and rectum ?
Every 3 to 6 months for 2 years, then
Every 6 months for a total of 5 years
#17 What clinical services are offered to patient during routine follow up ?
History to elicit GI and constitutional symptoms
Examination of the abdomen
Examination of the liver
Examination of the rectum
Examination of the perineum in patients who had an abdominal perineal resection
#18 What are the routine laboratory tests during follow up ?
Liver function test in patients who shows symptoms of recurrence
Carcinoembryonic antigen (CEA) test
#19 What is the clinical significance of rising CEA during follow up ?
It indicates hepatic or pulmonary metastases
#20 Which patients category is recommended to do follow up surveillance with CEA ?
Patients who have stage II tumor
Patients who have stage III tumor