title: Follow-up practice in endometrial cancer and the association with patient and hospital characteristics: a study from the population-based PROFILES registry.
abstract: OBJECTIVE
  To examine to what extent endometrial cancer survivors experienced follow-up according to the Dutch national guidelines, and to identify associations between follow-up care consumption and socio-demographic and clinical characteristics, Health-Related Quality of Life (HRQL), and worry (including fear of recurrence). Patients' preferences with the received follow-up care were also evaluated.
  
  
  METHODS
  All patients diagnosed with endometrial cancer FIGO stages I-II between 1999 and 2007, registered in the Eindhoven Cancer Registry (ECR), received a questionnaire including patients' follow-up care consumption, preferences regarding the follow-up schedule, HRQL (SF36 and EORTC-QLQ-EN24), and worry (IOCv2).
  
  
  RESULTS
  742 (77%) endometrial cancer survivors returned a completed questionnaire. Overall, 19% reported receiving more follow-up visits than recommended by the guidelines. Overconsumption of follow-up care was lowest in follow-up year 1 (13%), and highest in follow-up years 6-10 (27%). In addition, overconsumption was associated with having a comorbid condition, a higher score on the worry subscale, and hospital of treatment. Most patients (83%) felt comfortable with their follow-up schedule. Patients in follow-up years 6-10 felt least comfortable (69%).
  
  
  CONCLUSIONS
  Follow-up frequency was higher than recommended in a large group of endometrial cancer survivors, mainly in follow-up years 6-10. Moreover, a substantial variation in follow-up practice was observed between the different hospitals. Despite limited evidence to support the use of intensive follow-up schedules, the current study suggests that intensive routine follow-up after endometrial cancer continues to be standard practice. Possibly, patients should be better informed in order to reduce overconsumption and worry.
authors: CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands. K.A.H.nicolaije@uvt.nl
authors: Kim A H
authors: KA
authors: Nicolaije
authors: Nicole P M
authors: NP
authors: Ezendam
authors: M Caroline
authors: MC
authors: Vos
authors: Dorry
authors: D
authors: Boll
authors: Johanna M A
authors: JM
authors: Pijnenborg
authors: Roy F P M
authors: RF
authors: Kruitwagen
authors: Marnix L M
authors: ML
authors: Lybeert
authors: Lonneke V
authors: LV
authors: van de Poll-Franse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000523:psychology; D009426:Netherlands; D057240:Patient Preference / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012042:Registries; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D055815:Young Adult