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Aim: Patients treated with right‐sided hemicolectomy for colon cancer may suffer from long‐term bowel dysfunction, including loose stools, urgency and faecal incontinence. The underlying causes are poorly understood. The aim of this case–control study was to investigate the aetiology of chronic loose stools among patients with right‐sided hemicolectomy curatively operated for cancer. Method: Cases with chronic loose stools (Bristol stool type 6–7) after right‐sided hemicolectomy were compared with a control group of patients with right‐sided hemicolectomy without loose stools. All patients underwent a selenium‐75 homocholic acid taurine (SeHCAT) scan to diagnose bile acid malabsorption (BAM) and a glucose breath test to diagnose small intestinal bacterial overgrowth (SIBO). Gastrointestinal transit time (GITT) was assessed with radiopaque markers. In a subgroup of patients, fibroblast growth factor 19 (FGF19) was measured in fasting blood. SIBO was treated with antibiotics and BAM was treated with bile acid sequestrants. Results: We included 45 cases and 19 controls. In the case group, 82% (n = 36) had BAM compared with 37% (n = 7) in the control group, p < 0.001. SIBO was diagnosed in 73% (n = 33) of cases with chronic loose stools and in 74% (n = 14) of controls, p = 0.977. No association between BAM and SIBO was observed. GITT was similar in cases and controls. No difference in median FGF19 was observed between cases and controls (p = 0.894), and no correlation was seen between FGF19 and SeHCAT retention (rs 0.20, p = 0.294). Bowel symptoms among cases were reduced after treatment. Conclusion: BAM and SIBO are common in patients having undergone right‐sided hemicolectomy for cancer. Chronic loose stools were associated with BAM but not with SIBO. [ABSTRACT FROM AUTHOR]

Aim: Colorectal cancer survivors are one of the most rapidly growing groups of patients living with and beyond cancer. In a national multidisciplinary setting, we have examined the extent of late treatment‐related sequelae in colorectal cancer survivors and present the scientific evidence for management of these conditions in this patient category with the aim of facilitating identification and treatment. Method: A systematic search for existing guidelines and relevant studies was performed across 16 and 4 databases, respectively, from inception to 2021. This yielded 13 guidelines and 886 abstracts, of which 188 were included in the finalized guideline (231 included for full text review). Secondarily, bibliographies were cross‐referenced and 53 additional articles were included. Results: Symptoms have been divided into overall categories including psychosocial, bowel‐related, urinary, sexual (male and female), pain/neuropathy and fatigue symptoms or complaints that are examined individually. Merging and grading of data resulted in 22 recommendations and 42 management strategies across categories. Recommendations are of a more general character, whereas management strategies provide more practical advice suited for initiation on site before referral to specialized units. Conclusion: Treatment‐related sequelae in colorectal cancer survivors are common and attention needs to be focused on identifying patients with unmet treatment needs and the development of evidence‐based treatment algorithms. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to test the feasibility of a new method for systematic screening for late sequelae (LS) following colorectal cancer treatment. Method: Patients with colorectal cancer from five Danish hospitals were invited to complete a survey about LS at 3, 12, 24 and 36 months after surgery as part of their follow‐up. The survey consisted primarily of validated tools, supplemented by a few ad hoc items, measuring bowel, urinary and sexual dysfunction, pain and quality of life and an additional question regarding request for contact. Patients completed surveys electronically or on paper. Results: Of the 1721 invited patients, 1386 (80.5%) were included (1085 with colon cancer and 301 with rectal cancer) of whom 72.5% responded electronically. Patients responding electronically were 7.6 years younger than those responding on paper (P < 0.001). Since some patients answered more than once, the dataset consisted of 2361 surveys. Patients with colon cancer requested phone contact in 19.0% of the surveys, and 8.4% were referred to treatment for LS, primarily bowel dysfunction. Among patients with rectal cancer, 30.8% requested phone contact and 16.2% were referred for treatment of LS, mainly due to bowel and sexual dysfunction. Conclusion: This is the first paper investigating a new method of systematic screening for LS following colorectal cancer using electronic patient‐reported outcome measures. The study shows that in the Danish population a high response rate can be obtained with this method and that close to three‐quarters of patients respond electronically. Patients with rectal cancer had a higher need for phone contact and treatment of LS than patients with colon cancer. [ABSTRACT FROM AUTHOR]

The biggest problem currently is that REDCap cannot be integrated with our clinical electronic patient records, official registries etc., and hence data must be manually transferred from the database into the patients' files. It is likely that many of these comorbid patients who have survived treatment of a cancer will be motivated for an intervention of their underlying comorbidity and that this will lead to improved long-term outcome. The aim of follow-up after treatment for colorectal cancer (CRC) is twofold. In our opinion, there is a need to evaluate in randomized trials whether a systematic post-treatment management of patients with increased comorbidity can improve the long-term outcome. [Extracted from the article]