Consensus-based recommendation for surveillance of subsequent colorectal cancer

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for subsequent colorectal cancer?

CAYA cancer survivors treated with or with a history of

  • radiotherapy to a volume exposing the colon and rectum, including TBI

What surveillance modality should be used and at what frequency should it be performed?

  • Faecal occult blood testing every 3 years, to start 5 years after radiation or at the age of 30 years, whichever occurs last

  • As an alternative surveillance method, colonoscopy might be considered every 5 years, to start 5 years after radiation or at the age of 30 years, whichever occurs last

What should be done if abnormalities are identified?

  • Positive faecal occult blood testing should always be followed by a timely colonoscopy


While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.