Postoperative surveillance program was quite
uniformed among the respondents. Most programs
consisted of serum CEA measurement every 3 months in
the first 2 years, with or without routine liver imaging,
and colonoscopy at 1 year postoperatively. This program
could be classified as an intensive follow-up in several
studies, and there has been evidence that intensive followup
after curative resection of colorectal cancer improved
overall survival and re-resection rate for recurrent disease
(Tjandra and Chan, 2007). A national survey among Dutch
surgeons in 2007 showed that over 90% of surgeons such
an intensive follow-up protocol; serum CEA
measurements every 3 months in the first year and sixmonthly
thereafter, and ultrasound examination of the liver
every 6 months. Additionally, the most important factors
determining the follow-up protocol were age and physical
condition prohibiting metastasectomy or re-operation for
recurrent disease (Grossmann et al., 2007). In Thailand,
the surveillance system could be affected by patient’s
condition, physician’s preference, and socioeconomic
factors.
In conclusions, there is wide variation in CRC
screening and surveillance among Thai surgeons. These
results highlight the need to establish evidence-based and
cost-effective CRC screening and surveillance in
Thailand.