Rectal cancer has a much higher rate of local recurrence than colon cancer. Close follow-up may lead to the earlier diagnosis of recurrent disease and improved treatment. After treatment for rectal cancer, follow-up should include:
• Physical examination every two to three months for at least five years.
• Chest x-ray every 6 to 12 months for three to five years as indicated.
• Abdominal and pelvic CT scans twice a year for one to two years, then yearly.
• Serum chemistry profiles and CEA levels every 6 to 12 weeks (when operated on for a rising CEA level, 30 to
  40 percent may have a recurrent rectal cancer which may be successfully removed for cure).
• Barium enema as indicated. 
• Sigmoidoscopic examinations every 3 to 6 months and yearly colonoscopy .