Niloofar Memari1, Andrew Hayen2, Katy J L Bell1,3, Lucie Rychetnik4, Rachael L Morton1,5, Kirsten McCaffery1, John F Thompson6,7, Les Irwig1, Robin M Turner8. 1. School of Public Health, The University of Sydney, Sydney, NSW, Australia. 2. School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, Australia. 3. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia. 4. School of Medicine, University of Notre Dame Australia, Sydney, NSW, Australia. 5. Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 6. Melanoma Institute Australia, Sydney, NSW, Australia. 7. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. 8. School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, Australia. r.turner@unsw.edu.au.
Abstract
BACKGROUND: Post-treatment follow-up for patients with American Joint Committee on Cancer (AJCC) stage I/II melanoma is believed to be important for early detection of disease recurrence and new primary melanomas, but comes with costs to both patients and healthcare providers. We aimed to determine how frequently a cohort of patients attended follow-up after surgical treatment at one Specialist Center. METHODS: We used prospectively collected data from the Melanoma Institute Australia (MIA) for patients with AJCC stage I/II melanoma diagnosed between January 2008 and December 2011. The distribution of the number of recorded follow-up visits per patient was analyzed and compared with the number of follow-up visits recommended in the 2008 Australian and New Zealand Melanoma Management Guidelines. RESULTS: A total of 3813 patients with stage I/II melanoma were identified. During the first year of follow-up post-surgery, 34 % of stage I patients and 14 % of stage II patients had the number of follow-up visits recommended in the guidelines. A large proportion of melanoma patients did not appear to be routinely followed up at MIA, with 43.2 % of stage I patients and 28.7 % of stage II patients having either no visit or only one visit post-surgery. During all years of follow-up, 13.2 % of stage I patients and 4.1 % of stage II patients had the number of follow-up visits at the specialist center as recommended in the guidelines. CONCLUSIONS: The large proportion of patients who had fewer follow-up visits than expected suggests (i) many patients are followed up in clinics elsewhere, and/or (ii) post-surgical surveillance is less frequent in practice.
BACKGROUND: Post-treatment follow-up for patients with American Joint Committee on Cancer (AJCC) stage I/II melanoma is believed to be important for early detection of disease recurrence and new primary melanomas, but comes with costs to both patients and healthcare providers. We aimed to determine how frequently a cohort of patients attended follow-up after surgical treatment at one Specialist Center. METHODS: We used prospectively collected data from the Melanoma Institute Australia (MIA) for patients with AJCC stage I/II melanoma diagnosed between January 2008 and December 2011. The distribution of the number of recorded follow-up visits per patient was analyzed and compared with the number of follow-up visits recommended in the 2008 Australian and New Zealand Melanoma Management Guidelines. RESULTS: A total of 3813 patients with stage I/II melanoma were identified. During the first year of follow-up post-surgery, 34 % of stage I patients and 14 % of stage II patients had the number of follow-up visits recommended in the guidelines. A large proportion of melanomapatients did not appear to be routinely followed up at MIA, with 43.2 % of stage I patients and 28.7 % of stage II patients having either no visit or only one visit post-surgery. During all years of follow-up, 13.2 % of stage I patients and 4.1 % of stage II patients had the number of follow-up visits at the specialist center as recommended in the guidelines. CONCLUSIONS: The large proportion of patients who had fewer follow-up visits than expected suggests (i) many patients are followed up in clinics elsewhere, and/or (ii) post-surgical surveillance is less frequent in practice.
Authors: Wei-Yin Lim; Rachael L Morton; Robin M Turner; Marisa C Jenkins; Pascale Guitera; Les Irwig; Angela C Webster; Mbathio Dieng; Robyn P M Saw; Donald Low; Cynthia Low; Katy J L Bell Journal: JAMA Dermatol Date: 2018-04-01 Impact factor: 10.282
Authors: Deonna M Ackermann; Mbathio Dieng; Ellie Medcalf; Marisa C Jenkins; Cathelijne H van Kemenade; Monika Janda; Robin M Turner; Anne E Cust; Rachael L Morton; Les Irwig; Pascale Guitera; H Peter Soyer; Victoria Mar; Jolyn K Hersch; Donald Low; Cynthia Low; Robyn P M Saw; Richard A Scolyer; Dorothy Drabarek; David Espinoza; Anthony Azzi; Alister M Lilleyman; Amelia K Smit; Peter Murchie; John F Thompson; Katy J L Bell Journal: JAMA Dermatol Date: 2022-01-01 Impact factor: 11.816
Authors: Wei-Yin Lim; Robin M Turner; Rachael L Morton; Marisa C Jenkins; Les Irwig; Angela C Webster; Mbathio Dieng; Robyn P M Saw; Pascale Guitera; Donald Low; Cynthia Low; Katy J L Bell Journal: BMC Health Serv Res Date: 2018-06-20 Impact factor: 2.655
Authors: Deonna M Ackermann; Amelia K Smit; Monika Janda; Cathelijne H van Kemenade; Mbathio Dieng; Rachael L Morton; Robin M Turner; Anne E Cust; Les Irwig; Jolyn K Hersch; Pascale Guitera; H Peter Soyer; Victoria Mar; Robyn P M Saw; Donald Low; Cynthia Low; Dorothy Drabarek; David Espinoza; Jon Emery; Peter Murchie; John F Thompson; Richard A Scolyer; Anthony Azzi; Alister Lilleyman; Katy J L Bell Journal: Trials Date: 2021-05-04 Impact factor: 2.279
Authors: Andrea L Smith; Caroline G Watts; Samuel Robinson; Helen Schmid; Chiao-Han Chang; John F Thompson; Frances Rapport; Anne E Cust Journal: BJGP Open Date: 2020-06-23