A systematic review of patient perspectives on surveillance after colorectal cancer treatment

Berian, Julia R.; Cuddy, Amanda; Francescatti, Amanda B.; O’Dwyer, Linda; You, Y. Nancy; Volk, Robert J.; Chang, George J.

doi:10.1007/s11764-017-0623-2

Cited by 45 publications

(29 citation statements)

References 53 publications

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“…Besides content and frequency of follow-up, the surveillance setting (e.g. hospital-based, primary are-based or otherwise) is also highly variable [15,16]. Providing suitable follow-up for the growing number of CRC survivors can put pressure on outpatient services and compromise the ability to see new referrals or reassess patients [17].…”

Section: Introductionmentioning

confidence: 99%

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Qaderi

Swartjes

Custers

et al. 2020

European Journal of Surgical Oncology

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Follow-up after curative treatment for colorectal cancer (CRC) puts pressure on outpatient services due to the growing number of CRC survivors. The aim of this state-of-the-art review was to evaluate setting, manner and provider of follow-up. Moreover, perceptions of CRC survivors and health care providers regarding standard and alternative follow-up were examined. After a comprehensive literature search of the PubMed database, 69 articles were included reporting on CRC follow-up in the hospital, primary care and home setting. Hospital-based follow-up is most common and has been provided by surgeons, medical oncologists, and gastroenterologists, as well as nurses. Primary care-based follow-up has been provided by general practitioners or nurses. Even though most hospital-or primary care-based follow-up care requires patients to visit the clinic, telephone-based care has proven to be a feasible alternative. Most patients perceived follow-up as positive; valuing screening and detection for disease recurrence and appreciating support for physical and psychosocial symptoms. Hospital-based follow-up performed by the medical specialist or nurse is highly preferred by patients and health care providers. However, willingness of both patients and health care providers for alternative, primary care or remote follow-up exists. Nurse-led and GP-led follow-up have proven to be cost-effective alternatives compared to specialist-led follow-up. If proven safe and acceptable, remote follow-up can become a cost-effective alternative. To decrease the personal and financial burden of follow-up for a growing number of colorectal cancer survivors, a more acceptable, flexible and dynamic care follow-up mode consisting of enhanced communication and role definitions among clinicians is warranted.

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Section: Introductionmentioning

confidence: 99%

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Qaderi

Swartjes

Custers

et al. 2020

European Journal of Surgical Oncology

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“…While there is some research that seems to indicate that CRC survivorship care in primary care appears to be safe, adequate and cost-effective [ 10–12 ], some caregivers and patients feel reluctant towards primary care-led survivorship care [ 13–15 ]. Patients, in particular, seem to be undecided with some favouring secondary care and others favouring primary care [ 13 , 16 ]. It is unknown why certain patients prefer a certain type of caregiver, and to what extent symptoms that patients have influence this preference.…”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer patients’ preferences for type of caregiver during survivorship care

Wieldraaijer

Duineveld

Donkervoort

et al. 2018

Scandinavian Journal of Primary Health Care

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PurposeColorectal cancer (CRC) survivors are currently included in a secondary care-led survivorship care programme. Efforts are underway to transfer this survivorship care to primary care, but met with some reluctance by patients and caregivers. This study assesses (1) what caregiver patients prefer to contact for symptoms during survivorship care, (2) what patient factors are associated with a preferred caregiver, and (3) whether the type of symptom is associated with a preferred caregiver.MethodsA cross-sectional study of CRC survivors at different time points. For 14 different symptoms, patients reported if they would consult a caregiver, and who they would contact if so. Patient and disease characteristics were retrieved from hospital and general practice records.ResultsTwo hundred and sixty patients participated (response rate 54%) of whom the average age was 67, 54% were male. The median time after surgery was seven months (range 0–60 months). Patients were divided fairly evenly between tumour stages 1–3, 33% had received chemotherapy. Men, patients older than 65 years, and patients with chronic comorbid conditions preferred to consult their general practitioner (GP). Women, patients with stage 3 disease, and patients that had received chemotherapy preferred to consult their secondary care provider. For all symptoms, patients were more likely to consult their GP, except for (1) rectal blood loss, (2) weight loss, and (3) fear that cancer had recurred, in which case they would consult both their primary and secondary care providers. Patients appreciated all caregivers involved in survivorship care highly; with 8 out of 10 points.ConclusionsCRC survivors frequently consult their GP in the current situation, and for symptoms that could alarm them to a possible recurrent disease consult both their GP and secondary care provider. Patient and tumour characteristics influence patients’ preferred caregiver.

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“…Different views exist regarding a central the role of GPs in CRC follow-up. Some studies report positive views [18], while others demonstrate unfavorable views for a central role of GPs in follow-up [20,21]. The majority of our respondents disagreed with GP-led follow-up.…”

Section: Discussionmentioning

confidence: 64%

“…From a patient perspective, there is also willingness regarding non-physician follow-up such as GP-led or nurse-led follow-up [17][18][19]. Different views exist regarding a central the role of GPs in CRC follow-up.…”

Section: Discussionmentioning

confidence: 99%

Major differences in follow-up practice of patients with colorectal cancer; results of a national survey in the Netherlands

Qaderi

Wijffels²,

Bremers

et al. 2020

BMC Cancer

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Background: The precise content and frequency of follow-up of patients with colorectal cancer (CRC) is variable and guideline adherence is low. The aim of this study was to assess the view of colorectal surgeons on their local follow-up schedule and to clarify their opinions about risk-stratification and organ preserving therapies. Equally important, adherence to the Dutch national guidelines was determined. Methods: Colorectal surgeons were invited to complete a web-based survey about the importance and interval of clinical follow-up, CEA monitoring and the use of imaging modalities. Furthermore, the opinions regarding physical examination, risk-stratification, organ preserving strategies, and follow-up setting were assessed. Data were analyzed using quantitative and qualitative analysis methods. Results: A total of 106 colorectal surgeons from 52 general and 5 university hospitals filled in the survey, yielding a hospital response rate of 74% and a surgeon response rate of 42%. The follow-up of patients with CRC was mainly done by surgeons (71%). The majority of the respondents (68%) did not routinely perform physical examination during follow-up of rectal patients. Abdominal ultrasound was the predominant modality used for detection of liver metastases (77%). Chest X-ray was the main modality for detecting lung metastases (69%). During the first year of follow-up, adherence to the minimal guideline recommendations was high (99-100%). The results demonstrate that, within the framework of the guidelines, some respondents applied a more intensive follow-up and others a less intensive schedule. The majority of the respondents (77%) applied one single follow-up imaging schedule for all patients that underwent treatment with curative intent. Conclusions: Dutch colorectal surgeons' adherence to minimal guideline recommendations was high, but within the guideline framework, opinions differed about the required intensity and content of clinical visits, the interval of CEA monitoring, and the importance and frequency of imaging techniques. This national survey demonstrates current follow-up practice throughout the Netherlands and highlights the follow-up differences of curatively treated patients with CRC.

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A systematic review of patient perspectives on surveillance after colorectal cancer treatment

Cited by 45 publications

References 53 publications

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Colorectal cancer patients’ preferences for type of caregiver during survivorship care

Major differences in follow-up practice of patients with colorectal cancer; results of a national survey in the Netherlands

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