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Second Primary Colorectal Cancer: The Consequence of Management Failure at Several Potential Levels

Paul J. Limburg, MD, MPH; and David A. Ahlquist, MD
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From Mayo Clinic; Rochester, MN 55905.

Current Author Addresses: Drs. Limburg and Ahlquist: Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Ann Intern Med. 2002;136(4):335-337. doi:10.7326/0003-4819-136-4-200202190-00013
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Patients with previously diagnosed colorectal cancer are thought to be at increased risk for second primary large-bowel cancer (13). Widely endorsed surveillance guidelines promote regular colonoscopic evaluations after initial cancer resection in this high-risk group (45). Given the generally accepted progression from adenoma to carcinoma, an effective surveillance strategy would identify and remove both preinvasive and early invasive neoplasms so that cancer might be prevented or detected before metastasizing. However, few data have been available to evaluate the effectiveness of current approaches to postoperative surveillance in reducing the risk for and from subsequent colorectal cancer.

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