title: Patients' perspectives of long-term follow-up for localised cutaneous melanoma.
abstract: BACKGROUND
  Little is known about the value of long-term follow-up for localised cutaneous melanoma from the patients' perspective. This study aimed to explore the benefits and potential downsides of follow-up; feelings about changes to frequency of follow-up, and patient-centred recommendations for improving follow-up care.
  
  
  METHODS
  Qualitative analysis of 29 in-depth interviews conducted with Australian patients undergoing long-term follow-up after surgical treatment of stage I/II melanoma.
  
  
  RESULTS
  Patient-perceived benefits of follow-up included reassurance, early detection of new melanomas and non-melanoma skin cancers, education about skin self-examination, the opportunity to ask questions, and reinforcement of 'sunsafe' behaviours. Downsides included anxiety leading up to and during follow-up visits; inconvenience of travel to attend visits; and lost work time. Patients varied in their engagement with skin self-examination, and their views on multiple skin excisions, but highly valued access to specialists for unscheduled visits. Most patients felt their follow-up intervals could be extended to 12 months if recommended by their clinician.
  
  
  CONCLUSIONS
  The benefits and potential downsides of follow-up should be discussed with patients when deciding on a melanoma follow-up plan to achieve a balance between inducing additional patient anxiety and providing reassurance. Follow-up intervals of 12 months appear to be acceptable to patients.
authors.affiliation: School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia. rachael.morton@sydney.edu.au
authors.forename: R L
authors.initials: RL
authors.lastname: Morton
authors.forename: L
authors.initials: L
authors.lastname: Rychetnik
authors.forename: K
authors.initials: K
authors.lastname: McCaffery
authors.forename: J F
authors.initials: JF
authors.lastname: Thompson
authors.forename: L
authors.initials: L
authors.lastname: Irwig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001315:Australia; D055088:Early Detection of Cancer / Q000009:adverse effects / Q000379:methods; D005260:Female; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D010353:Patient Education as Topic; D036301:Qualitative Research; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology* / Q000601:surgery