C C Earle1, E Grunfeld, D Coyle, M C Cripps, H S Stern. 1. Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA. craig_earle@dfci.harvard.edu
Abstract
BACKGROUND: The optimal follow-up strategy for colorectal cancer is unknown. MATERIALS AND METHODS: We surveyed all Canadian radiation oncologists, medical oncologists and surgeons specializing in colorectal cancer to assess their recommendations for follow-up after potentially curative treatment, the beliefs and attitudes underlying these practices, and the cost implications of different follow-up strategies. RESULTS: One hundred and sixty practitioners (58%) returned completed surveys. Most recommended clinical assessments every 3-4 months in the first 2 years including carcino-embryonic antigen testing, gradually decreasing in frequency over 5 years. Ninety per cent recommend a surveillance colonoscopy in the first year. The majority felt that specialist involvement in follow-up was important because of the increased opportunities for patients to contribute to research (76%) and teaching (73%). About half felt that specialists were more efficient at providing follow-up than primary care physicians, but these same physicians recommended significantly longer and more expensive follow-up routines on average than others. Primary care physicians were felt to be important allies, especially in managing the psychosocial concerns of patients. CONCLUSIONS: Surveillance practices are generally in keeping with published recommendations. Most specialists feel that they should remain involved in follow-up, but this may result in increased resource utilization.
BACKGROUND: The optimal follow-up strategy for colorectal cancer is unknown. MATERIALS AND METHODS: We surveyed all Canadian radiation oncologists, medical oncologists and surgeons specializing in colorectal cancer to assess their recommendations for follow-up after potentially curative treatment, the beliefs and attitudes underlying these practices, and the cost implications of different follow-up strategies. RESULTS: One hundred and sixty practitioners (58%) returned completed surveys. Most recommended clinical assessments every 3-4 months in the first 2 years including carcino-embryonic antigen testing, gradually decreasing in frequency over 5 years. Ninety per cent recommend a surveillance colonoscopy in the first year. The majority felt that specialist involvement in follow-up was important because of the increased opportunities for patients to contribute to research (76%) and teaching (73%). About half felt that specialists were more efficient at providing follow-up than primary care physicians, but these same physicians recommended significantly longer and more expensive follow-up routines on average than others. Primary care physicians were felt to be important allies, especially in managing the psychosocial concerns of patients. CONCLUSIONS: Surveillance practices are generally in keeping with published recommendations. Most specialists feel that they should remain involved in follow-up, but this may result in increased resource utilization.
Authors: Julia R Berian; Amanda Cuddy; Amanda B Francescatti; Linda O'Dwyer; Y Nancy You; Robert J Volk; George J Chang Journal: J Cancer Surviv Date: 2017-06-22 Impact factor: 4.442
Authors: Arnold L Potosky; Paul K J Han; Julia Rowland; Carrie N Klabunde; Tenbroeck Smith; Noreen Aziz; Craig Earle; John Z Ayanian; Patricia A Ganz; Michael Stefanek Journal: J Gen Intern Med Date: 2011-07-22 Impact factor: 5.128
Authors: Jensen Tan; Jennifer Muir; Natalie Coburn; Simron Singh; David Hodgson; Refik Saskin; Alex Kiss; Lawrence Paszat; Abraham El-Sedfy; Eva Grunfeld; Craig Earle; Calvin Law Journal: Can J Gastroenterol Hepatol Date: 2014-07-11