title: The process and outcomes of a nurse-led colorectal cancer follow-up clinic.
abstract: OBJECTIVE
  Evidence suggests that follow-up after colorectal cancer improves survival. Colorectal cancer is so common that patient follow-up can overwhelm a service, affecting the ability to see new referrals and reassess patients seen previously who have new symptoms. In order to cope with this demand a nurse-led follow-up service was started in 2004. We aimed to review the results of a nurse-led colorectal cancer follow-up clinic.
  
  
  METHODS
  Between 1 December 2004 and 31 January 2011, patients who underwent resection for colorectal cancer were followed up by a nurse specialist according to a protocol determined by the colorectal surgeons in the unit. All patient details were recorded prospectively in a purpose designed database.
  
  
  RESULTS
  Nine hundred and fifty patients were followed up over 7 years. Some 368 patients were discharged from the follow-up programme, 474 patients remain actively involved in the programme and 108 patients died. Of the patients discharged from the follow-up scheme 269 (73%) were discharged to their general practitioner free of disease after 5 years. Of the 108 who patients died, 98 were as a result of colorectal cancer. Twenty patients (2.1%) were identified with local (peri-anastomotic) disease recurrence and 93 patients (9.8%) were found to have developed distant metastatic disease. Of these, 65 patients (6.8%) were referred for palliative care and 28 (2.9%) had surgery for focal metastatic disease of whom 18 were still alive at the time of this analysis.
  
  
  CONCLUSIONS
  This paper shows that a nurse-led clinic for colorectal cancer follow-up can achieve satisfactory results with detection rates of recurrent or metastatic disease comparable to consultant follow-up. A nurse-led clinic provides the benefits of follow-up without overwhelming the consultant colorectal surgical clinic practice.
authors.affiliation: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: K
authors.initials: K
authors.lastname: McFarlane
authors.forename: L
authors.initials: L
authors.lastname: Dixon
authors.forename: C J
authors.initials: CJ
authors.lastname: Wakeman
authors.forename: G M
authors.initials: GM
authors.lastname: Robertson
authors.forename: T W
authors.initials: TW
authors.lastname: Eglinton
authors.forename: F A
authors.initials: FA
authors.lastname: Frizelle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D019091:Critical Pathways; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D057184:Practice Patterns, Nurses'; D012017:Referral and Consultation; D055815:Young Adult