title: Follow-up after colon cancer treatment in the Netherlands; a survey of patients, GPs, and colorectal surgeons.
abstract: BACKGROUND
  Follow-up to detect recurrence is an important feature of care after colon cancer treatment. Currently, follow-up visits are surgeon-led with focus on recurrence. To date, there is increasing interest for general practitioners (GPs) providing this care, as GPs might provide more holistic care. The present study assessed how surgeons, GPs, and patients evaluate current surgeon-led colon cancer follow-up and to list their views on possible future GP-led follow-up.
  
  
  METHODS
  The study consists of a cross-sectional survey including colorectal surgeons, patients who participate or recently finished a follow-up programme, and GPs in the Netherlands.
  
  
  RESULTS
  Eighty-seven out of 191 GPs, 113 out of 238 surgeons, and 186 out of 243 patients responded. Patients are satisfied about current surgeon-led follow-up, especially about recurrence detection and identification of physical problems (94% and 85% respectively). However, only 56% and 49% of the patients were satisfied about the identification of psychological and social problems respectively. Only 16% of the patients evaluated future GP-led follow-up positively. Regarding healthcare providers, surgeons were more positive compared to GPs; 49% of the surgeons, and only 30% of the GPs evaluated future GP-led follow-up positively (P = 0.002). Furthermore, several reservations and principle requirements for GP-led follow-up were identified.
  
  
  CONCLUSIONS
  The results suggest an unfavourable view among patients and healthcare providers, especially GPs, regarding a central role for GPs in colon cancer follow-up. However, low satisfaction on psychosocial aspects in current follow-up points out a lack in care. Therefore, the results provide a justification to explore future GP-led care further.
authors.affiliation: Department of Primary Care, Academic Medical Centre, Amsterdam, The Netherlands. j.wind@amc.uva.nl
authors.forename: J
authors.initials: J
authors.lastname: Wind
authors.forename: L A
authors.initials: LA
authors.lastname: Duineveld
authors.forename: R P
authors.initials: RP
authors.lastname: van der Heijden
authors.forename: K M
authors.initials: KM
authors.lastname: van Asselt
authors.forename: W A
authors.initials: WA
authors.lastname: Bemelman
authors.forename: H C
authors.initials: HC
authors.lastname: van Weert
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017024:Chemotherapy, Adjuvant; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D003107:Colorectal Surgery / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D020380:Needs Assessment; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D010358:Patient Participation / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Colon cancer; Follow-up; General practitioner; Malignancy; Oncology; Primary care