Colorectal cancer
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Follow-up after curative treatment
Laboratory tests
- Carcinoembryonic antigen (CEA)if neededIf CEA was raised before surgery: one measurement 6 to 8 weeks after surgery to check that it has normalised [2,3]. Further measurements only if the oncology team has scheduled them: TNCD (French National Thesaurus of Digestive Cancers) no longer recommends them routinely [2,3].
Also consider
- Fluoropyrimidine planned? Before 5-FU or capecitabine, uracilaemia testing is mandatory: see the Pharmacogenetics page.
Do not order
- CEA (or another tumour marker) to screen for or diagnose colorectal cancer: the lack of sensitivity for early cancers and of specificity rules out serum markers for the primary diagnosis of cancer [10], and the French laboratory fee schedule (NABM) covers CEA only for treatment monitoring [11]. Screening relies on the faecal immunochemical test [6]: see the page “Colorectal cancer screening (faecal immunochemical test)”; raised CEA found with no known cancer: see the page “Raised tumour marker outside cancer follow-up (CEA, CA 19-9, CA 125, AFP)”.
- Alkaline phosphatase to monitor for recurrence: poorly specific, not recommended [3].
- Repeated CEA measurements beyond the oncology team's programme, or after 5 years: CEA surveillance is no longer recommended by TNCD [2,3] and did not improve survival in PRODIGE 13 [5].
Sources (11)
- Santé publique France. Cancer du colon rectum (dossier « Cancer du côlon-rectum », rubrique Données), consulté le 13/10/2026.
- Thésaurus national de cancérologie digestive (TNCD, SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO…). Chapitre 3 : Cancer du côlon non métastatique. Version du 13/02/2026.
- Thésaurus national de cancérologie digestive (TNCD). Chapitre 5 : Cancer du rectum (avec le GRECCAR). Version du 05/01/2025.
- HAS : Tumeur maligne, affection maligne du tissu lymphatique ou hématopoïétique Cancer colorectal. Guide du parcours de soins ALD 30, HAS et INCa, février 2008.
- Lepage C, Phelip JM, Cany L, et al. Effect of 5 years of CT-scan and CEA follow-up on survival endpoints in patients with colorectal cancer: the PRODIGE-13 FFCD phase III trial. Ann Oncol. 2025;36(12):1468-1479.
- Duffy MJ, Lamerz R, Haglund C, et al. Tumor markers in colorectal cancer, gastric cancer and gastrointestinal stromal cancers: European Group on Tumor Markers 2014 guidelines update. Int J Cancer. 2014;134(11):2513-22.
- National Institute for Health and Care Excellence. Colorectal cancer (NG151). Recommandation 1.6.1 (surveillance après traitement à visée curative) et sa justification. Publiée le 29 janvier 2020, dernière mise à jour le 15 décembre 2021.
- El-Shami K, Oeffinger KC, Erb NL, et al. American Cancer Society Colorectal Cancer Survivorship Care Guidelines. CA Cancer J Clin. 2015;65(6):428-55.
- Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Kolorektales Karzinom, Langversion 3.2, mars 2026, registre AWMF 021-007OL, chapitre 11 « Nachsorge ».
- Duffy MJ. Tumor markers in clinical practice: a review focusing on common solid cancers. Med Princ Pract. 2013;22(1):4-11.
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 7327 (antigène carcino-embryonnaire).