AIMS: The investigators aim is to determine whether there is a difference in SWS between current patterns of care and NHMRC recommendations. Secondary outcomes will include whether there is any difference between recurrence rates or death rates in those who had follow up according to guidelines and those who did not, and whether distance from hospital, age or CALD status impacted on pattern of care.

METHOD: Patients with stage III colon cancer who were treated in a large, multiple surgeon run clinic rooms were identified from those discussed at a large tertiary referral centre Colorectal Cancer Multidisciplinary Meeting between Jan 2007 and Dec 2009. In the immediate 5 year postoperative surveillance period, CEA measurements, colonoscopies and CT scans for each of these patients were obtained both from private clinic records, outside pathology and hospital records for the 24 patients identified who met the inclusion criteria. This project is ongoing, and we aim to identify approximately 50 patients by November. The frequency of each was then compared to NHMRC guidelines to assess whether current patterns of care reflect current recommendations. Language spoken, home suburb, recurrences and deaths were also noted.

RESULTS: Following a median follow up period of 4.5 years, 20 from 24 (86%) patients were followed up for history and examination in the appropriate timeframes.  However, only 8 (33%) of the cohort had CEA measurement every 6 months or less as suggested by NHMRC guidelines (this does increase to 14 (58%) allowing for one late or missed measurement). As could be expected in such a population,at the time of analysis 10 of the 24 (42%) had evidence of a recurrence, and 2 of these had died from their colon cancer. There is a correlation between CEA measurement and rate of recurrence (chi-square 10.4, p=0.001), however our numbers are too small to determine whether this translates to a reduction in death rate. There was no difference in rates of surveillance based on the patient factors analysed.