Follow-up intensity after colorectal cancer surgery in patients aged ≤ 50, 50-70 and > 70 years - an analysis within the COLOFOL randomised clinical trial
Gutlic, Ida LU
; Veres, Katalin
; Horváth-Puhó, Erzsébet
; Lydrup, Marie Louise
LU
and Buchwald, Pamela
LU
(2026)
In International Journal of Colorectal Disease
41.
- Abstract
PURPOSE: The incidence of colorectal cancer (CRC) is increasing in individuals aged < 50 years of age. This study aimed to examine whether high-frequency follow-up after CRC surgery reduces 5-year overall mortality, cancer-specific mortality and recurrence in patients with CRC aged ≤ 50 years. METHODS: The COLOFOL trial performed between 2006 and 2010 was used to analyse patients randomised to high-frequency (computed tomography [CT] of the abdomen and thorax and a carcinoembryonic antigen [CEA] test at 6, 12, 18, 24 and 36 months) versus low-frequency (CT and CEA at 12 and 36 months) follow-up after curative CRC surgery. Intention-to-treat and per-protocol analyses were performed to study the primary outcomes (5-year overall... (More)
PURPOSE: The incidence of colorectal cancer (CRC) is increasing in individuals aged < 50 years of age. This study aimed to examine whether high-frequency follow-up after CRC surgery reduces 5-year overall mortality, cancer-specific mortality and recurrence in patients with CRC aged ≤ 50 years. METHODS: The COLOFOL trial performed between 2006 and 2010 was used to analyse patients randomised to high-frequency (computed tomography [CT] of the abdomen and thorax and a carcinoembryonic antigen [CEA] test at 6, 12, 18, 24 and 36 months) versus low-frequency (CT and CEA at 12 and 36 months) follow-up after curative CRC surgery. Intention-to-treat and per-protocol analyses were performed to study the primary outcomes (5-year overall mortality and cancer-specific mortality) and the secondary outcome (CRC recurrence), comparing the age groups ≤ 50, 51-70 and > 70 years. RESULTS: In total, 2,509 patients were included in the intention-to-treat analysis with 183, 1,714 and 612 patients aged ≤ 50, 51-70 and > 70 years, respectively. The 5-year overall mortality risk for patients aged ≤ 50 was 8.3% in the high-frequency group compared with 8.4% in the low-frequency group (risk difference 0.2% [95% CI, - 8.0; 8.3]). The cancer-specific mortality risk for patients aged ≤ 50 years was 7.1% in the high-frequency group compared with 7.4% in the low-frequency group (risk difference, 0.3% [95% CI, - 7.4; 8.0]). The cancer-specific recurrence risk for patients aged ≤ 50 years was 12.9% in the high-frequency group compared with 21.0% in the low-frequency group (risk difference 8.1% [95% CI, - 2.6; 18.7]). CONCLUSION: Among individuals aged ≤ 50 years with stage II-III CRC, there was no reduction in overall mortality, cancer-specific mortality and cancer-specific recurrence with more intensive follow-up using CT and CEA.
(Less)
- author
- Gutlic, Ida
LU
; Veres, Katalin
; Horváth-Puhó, Erzsébet
; Lydrup, Marie Louise
LU
and Buchwald, Pamela
LU
- author collaboration
- organization
- publishing date
- 2026-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Colorectal cancer, Early-onset, Follow-up, Sweden
- in
- International Journal of Colorectal Disease
- volume
- 41
- article number
- 47
- publisher
- Springer
- external identifiers
-
- pmid:41586910
- scopus:105028692540
- ISSN
- 1432-1262
- DOI
- 10.1007/s00384-026-05096-9
- language
- English
- LU publication?
- yes
- id
- e120d023-4156-4d33-a90e-6cf627983722
- date added to LUP
- 2026-02-19 14:02:24
- date last changed
- 2026-02-20 03:00:02
@article{e120d023-4156-4d33-a90e-6cf627983722,
abstract = {{<p>PURPOSE: The incidence of colorectal cancer (CRC) is increasing in individuals aged < 50 years of age. This study aimed to examine whether high-frequency follow-up after CRC surgery reduces 5-year overall mortality, cancer-specific mortality and recurrence in patients with CRC aged ≤ 50 years. METHODS: The COLOFOL trial performed between 2006 and 2010 was used to analyse patients randomised to high-frequency (computed tomography [CT] of the abdomen and thorax and a carcinoembryonic antigen [CEA] test at 6, 12, 18, 24 and 36 months) versus low-frequency (CT and CEA at 12 and 36 months) follow-up after curative CRC surgery. Intention-to-treat and per-protocol analyses were performed to study the primary outcomes (5-year overall mortality and cancer-specific mortality) and the secondary outcome (CRC recurrence), comparing the age groups ≤ 50, 51-70 and > 70 years. RESULTS: In total, 2,509 patients were included in the intention-to-treat analysis with 183, 1,714 and 612 patients aged ≤ 50, 51-70 and > 70 years, respectively. The 5-year overall mortality risk for patients aged ≤ 50 was 8.3% in the high-frequency group compared with 8.4% in the low-frequency group (risk difference 0.2% [95% CI, - 8.0; 8.3]). The cancer-specific mortality risk for patients aged ≤ 50 years was 7.1% in the high-frequency group compared with 7.4% in the low-frequency group (risk difference, 0.3% [95% CI, - 7.4; 8.0]). The cancer-specific recurrence risk for patients aged ≤ 50 years was 12.9% in the high-frequency group compared with 21.0% in the low-frequency group (risk difference 8.1% [95% CI, - 2.6; 18.7]). CONCLUSION: Among individuals aged ≤ 50 years with stage II-III CRC, there was no reduction in overall mortality, cancer-specific mortality and cancer-specific recurrence with more intensive follow-up using CT and CEA.</p>}},
author = {{Gutlic, Ida and Veres, Katalin and Horváth-Puhó, Erzsébet and Lydrup, Marie Louise and Buchwald, Pamela}},
issn = {{1432-1262}},
keywords = {{Colorectal cancer; Early-onset; Follow-up; Sweden}},
language = {{eng}},
publisher = {{Springer}},
series = {{International Journal of Colorectal Disease}},
title = {{Follow-up intensity after colorectal cancer surgery in patients aged ≤ 50, 50-70 and > 70 years - an analysis within the COLOFOL randomised clinical trial}},
url = {{http://dx.doi.org/10.1007/s00384-026-05096-9}},
doi = {{10.1007/s00384-026-05096-9}},
volume = {{41}},
year = {{2026}},
}