# Follow-up after curative treatment for colorectal cancer

Source: https://onco.cc/protocols/colorectal-cancer-follow-up-after-curative-treatment/  
OnCo record `colorectal-cancer-follow-up-after-curative-treatment` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

After an operation to cure bowel cancer, you will usually have regular blood tests (CEA) and CT scans for the first 3 years, and a colonoscopy about a year after surgery. The aim is to find a return early enough to operate again. How often you are tested differs between countries, and the large trials found that testing more often does not, on average, help people live longer.

## Summary

NICE NG151 offers follow-up for the first 3 years after potentially curative surgery for non-metastatic colorectal cancer, with serum carcinoembryonic antigen (CEA) and CT of the chest, abdomen and pelvis, and does not set a frequency. The American Cancer Society (2015) endorses the NCCN schedule for stages I to III: history and examination and CEA every 3 to 6 months for 2 years, then every 6 months to 5 years; CT every 12 months; colonoscopy at 1 year. ASCO (2013) gives CEA every 3 to 6 months for 5 years and CT annually for 3 years in most cases. Colonoscopy is at 1 year after surgery in all these sources; the next is after 3 more years (BSG/ACPGBI 2020, NCCN) or 5 years (ASCO). PET-CT is not a surveillance test.

The evidence for intensity is weak: the 2019 Cochrane review of 19 randomised trials (13,216 people) found that intensive follow-up made little or no difference to overall survival (hazard ratio 0.91, high-quality evidence), although it nearly doubled salvage surgery with curative intent. Surveillance is only for people fit for further surgery or treatment, and colonoscopic surveillance stops in general at about 75 or with a life expectancy under 10 years (BSG/ACPGBI). People who had sphincter-preserving surgery should be told about low anterior resection syndrome and how to get help (NICE).

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: bowel cancer follow-up; colorectal cancer surveillance; CEA and CT surveillance after bowel cancer; colonoscopy after bowel cancer surgery
- Tags: protocol; follow-up; survivorship

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [CEA surveillance after colorectal cancer surgery](https://onco.cc/technologies/cea-surveillance-colorectal/), [Survivorship care and late-effects surveillance](https://onco.cc/technologies/survivorship-care-plan/)
- institutions: [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/), [National Institute for Health and Care Excellence](https://onco.cc/institutions/nice/)
- terms: [Colonoscopy](https://onco.cc/terms/colonoscopy/), [Low anterior resection syndrome (LARS)](https://onco.cc/terms/low-anterior-resection-syndrome/)
- ideas: [Risk-stratified follow-up: low-risk survivors to primary care with fast re-entry](https://onco.cc/ideas/idea-acc-risk-stratified-follow-up/)
- protocols: [End of treatment: treatment summary, survivorship care plan and handover to primary care](https://onco.cc/protocols/survivorship-care-plan-and-treatment-summary/)

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