Purpose: A significant reduction in colorectal cancer (CRC) mortality is attributed to CRC screening and
surveillance. However, there is no national consensus on CRC screening and surveillance in Thailand. The aim
of this study was to assess current practice in CRC screening and surveillance among Thai general surgeons.
Methods: Between July and November 2008, a questionnaire was randomly sent to general surgeons nationwide,
mainly to those who worked in the General Province Hospital or University Hospital. Their responses were
analyzed. Results: One hundred and twelve general surgeons completed questionnaires (56% response rate);
about 39% of them were colorectal surgeons. Ninety-four surgeons (84%) routinely offered CRC screening to
an asymptomatic, average-risk population. Most surgeons started CRC screening in an average-risk patient at
the age of 50 years and did no screening in populations with age above 80 years. Colonoscopy is the most popular
investigation used in CRC screening, followed by fecal occult blood testing and double contrast barium enema.
When the surgeons themselves were subjected to CRC screening, colonoscopy was also the favorite investigation
used. About 3-18% of surgeons showed interest in CRC screening with computed tomographic colonography.
After curative CRC resection, most surgeons set up a surveillance program with examinations every 3 months
in the first 2 years and performed post-CRC resection surveillance by colonoscopy at 1 year. Conclusions: There
is a 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.
Key Words: Colorectal cancer - screening - surveillance - survey - Thai surgeons