O156: Post-operative surveillance following curative resection of colorectal cancer in an elderly population

Abstract

Abstract Introduction There are over 42,000 new cases of colorectal cancer in the UK each year with the highest incidence rates in those aged 85-89. Post-colorectal cancer surveillance aims to reduce cancer incidence and mortality, but its necessity and effectiveness remain debated especially in an elderly population. This study explores the relevance of computer tomography (CT) and colonoscopy surveillance in patients aged 75 and over who have undergone curative resection for colorectal cancer. Methods A retrospective analysis of prospectively collected data was conducted on patients aged 75 and over who had undergone surgical resection of colorectal cancer between November 2014 and August 2021. Data on demographics, treatment, survival, and surveillance were gathered from electronic patient records. The primary outcome was adherence to follow-up colonoscopy and CT-scan surveillance following surgery. Results A total of 417 patients underwent colorectal cancer surgery, with 334 included for analysis. Twelve-month CT surveillance showed normal results in 91.8% of cases, while 24-month CT surveillance demonstrated normal findings in 88.7%. Only 52.4% had colonoscopy follow-up, with 53.7% showing normal results, 42.3% demonstrated benign polyps, and 1.1% had histologically proven cancer. Reasons for not undergoing colonoscopy included patient preference (19.1%) and frailty (28.7%). Conclusion This study reinforces the notion that colonoscopy surveillance in patients over 75 may have limited benefits. In an aging population, benefits of surveillance in terms of early detection of recurrence must be balanced against the risks of harm from the procedure, availability of further management, cost-effectiveness, and patients’ preference.