More intensive monitoring allows earlier detection of recurring colon cancer

A new type of post-operative check-up for patients treated for colorectal cancer allows for earlier detection of recurrence of the disease. This method involves more frequent blood testing for the presence of the tumour marker CEA (Carcinoembryonic Antigen); if there is an increase, the physician can respond immediately. These patients have a higher recovery rate than with the current monitoring method. This is the conclusion of PhD research conducted by Charlotte Verberne at the UMCG. The new method is also more cost effective, and patients are positive about the diagnostics process. Verberne will be awarded a PhD for her research by the University of Groningen on 3 February.

In the Netherlands, over 13,000 patients are diagnosed with colorectal cancer every year. Treatment aims to surgically remove the tumour. After the treatment, patients are monitored by their physician. The main goal is early detection of recurrence of the disease; some 20-25% of all patients experience recurrence. Charlotte Verberne has studied the role of the level of the tumour marker CEA in the blood during the monitoring of colorectal cancer. In most patients (up to 80%), the CEA level rises if the disease returns.

Verberne used patient data from 11 Dutch hospitals to determine the effect of the new check-up protocol. The new protocol consisted of bi-monthly CEA tests and a CT scan of the abdomen and lungs if there is a noticeable increase in the CEA level. The current guideline also tests CEA levels, but only every 3 or 6 months, and without a CT scan follow-up. Verberne studied 3223 patients over the course of two years. The results of her study show that recurrence of the disease can be detected earlier than with the current monitoring method. Patients with recurring colorectal cancer showed better chances for cure of this recurrence (35% compared to 22%) than patients who were monitored according to the current Dutch guideline.

Verberne used questionnaires to determine what patients thought about this new way of monitoring. They showed that the new protocol has no adverse effects on the patient’s attitude towards the follow-up, nor does it affect patients’ physical functioning. Verberne states that patients are positive about the new follow-up method. Her study also shows that the new protocol is cost effective.

Verberne’s results show that new protocol is better at detecting recurring cancer than the current Dutch guideline. ‘At this time, we have no numbers for the survival rate after 5 and 10 years’, says Verberne. If more research reveals positive results here too, she would recommend the adoption of this new protocol in the Dutch healthcare system. ‘Any follow-up research should focus on long term survival,’ she says.

Curriculum vitae

C.J. Verberne (Zierikzee, 1983) studied Medicine at the University of Groningen. The title of her thesis is Carcinoembryonic Antigen (CEA) in colorectal cancer follow-up. Her supervisors were Prof. T. Wiggers and Prof. G de Bock. Verberne is currently employed as a surgeon-in-training at the Medisch Spectrum Twente in Enschede (The Netherlands).

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