Follow-up care for cancer survivors: the views of clinicians.
BACKGROUND
Evidence for the efficacy of late effects surveillance in adult cancer survivors is lacking and there is little agreement among clinicians on appropriate follow-up care.


METHODS
We report the views of both cancer experts and general practitioners (GPs) on long-term follow-up provision for cancer survivors, focussing on the 18-45 years age group. A total of 421 cancer experts (36% haematologists, 33% oncologists, 18% surgeons, 10% nurses, 2% other) and 54 GPs responded to a structured online survey. Reasons for follow-up care (clinical or supportive); advantages and disadvantages of follow-up in primary care; current practice; and resources required for a quality follow-up service were assessed.


RESULTS
Clinicians valued clinical reasons for follow-up more highly than supportive reasons (P<0.001). Learning more about late effects and checking for cancer recurrence were rated as the most important reasons for follow-up by cancer experts and GPs. A total of 85% of cancer specialists hold follow-up consultations alongside patients on active treatment. Cancer experts agreed that primary care follow-up would increase their availability for acute oncological care, but reduce information on late effects. The most important resource to provide a quality follow-up service was specialist nursing support (91%).


CONCLUSIONS
Follow-up guidelines that include late effects surveillance are needed. Where and who should deliver this care requires further debate.
Greenfield
D M
DM
Academic Unit of Clinical Oncology, Weston Park Hospital, WhithamRoad, Sheffield S10 2SJ, UK. d.greenfield@sheffield.ac.uk
Absolom
K
K
Eiser
C
C
Walters
S J
SJ
Michel
G
G
Hancock
B W
BW
Snowden
J A
JA
Coleman
R E
RE
D000293:Adolescent; D000328:Adult; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000379:methods; D017408:Guidelines as Topic; D006801:Humans; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010820:Physicians; D010821:Physicians, Family; D011364:Professional Practice; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D055815:Young Adult