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Colon Cancer Follow-Ups Need Improvement

Posted by Jane Akre
Wednesday, September 10, 2008 11:28 AM EST
Category: Major Medical, Protecting Your Family
Tags: Colon Cancer, Cancer, Colonoscopy, FDA and Prescription Drugs, U.S. Hospitals

Followup of colon cancer patients is inadequate at many U.S. hospitals, two studies find.



IMAGE SOURCE: Wikicommons/ Euchiasmus


Doctors need to do more to improve treatment of colon cancer patients, two studies conclude. 

The first study finds the majority of U.S. hospitals, 62 percent, are not testing enough lymph nodes after surgery to make sure the disease hasn’t spread.

That study appears in the Journal of the National Cancer Institute.

The second study appearing in the journal Cancer, finds that the majority, 60 percent, of those under treatment for colon cancer are not receiving all of the recommended follow-up tests.  

While 92 percent went to a follow-up visit, half of that number had a subsequent colonoscopy.

Colon cancer is the second leading cause of death in the U.S. and as many as 80 percent of patients have the disease localized. Surgeons look at the surrounding lymph nodes to determine if the cancer has spread.

The conclusion – a low number of hospitals are in compliance with recommended treatment protocols which suggest at least a dozen lymph nodes be examined for cancer. 

"Examining 12 or more lymph nodes ensures adequate staging," said the lead author of the first study, Dr. Karl Bilimoria, a surgical resident at the Feinberg School of Medicine at Northwestern University in Chicago tells U.S. News. 

If cancer is found, it’s recommended the patient receive chemotherapy to prevent further spread of the cancer.  Without a finding of cancer, surgery is the only recommended treatment.

Dr. Bilimoria and colleagues reviewed data from almost 1,300 U.S. hospitals and overall found just 38 percent were compliant. Still that is an improved picture by 23 percent from 1996.

What can patients do?

  • Ask your doctor after colon cancer surgery is they took out 12 or more lymph nodes
  • Ask to see the pathology report to ensure all have been checked
  • Have routine and regular follow-up visits with your doctor
  • Have blood tested and periodic colonoscopies

Coming in first in efficiency were the National Cancer Institute-designated Comprehensive Cancer Centers – 78 percent compliant.

Next, the Veterans Administration hospitals – 58 percent compliant;  followed by academic hospitals – 52.4 percent compliant.

At the bottom of the list were community hospitals with about 30 percent checking the 12 lymph nodes after surgery.   #

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