Cancer physicians' attitudes toward colorectal cancer follow-up.
BACKGROUND
The optimal follow-up strategy for colorectal cancer is unknown.


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.
Earle
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CC
Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA. craig_earle@dfci.harvard.edu
Grunfeld
E
E
Coyle
D
D
Cripps
M C
MC
Stern
H S
HS
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002170:Canada; D002272:Carcinoembryonic Antigen / Q000032:analysis; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D010819:Physician's Role; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D018787:Radiation Oncology; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen