title: Remote surveillance after colorectal cancer surgery: an effective alternative to standard clinic-based follow-up.
abstract: OBJECTIVE
  Most colorectal cancer recurrences are asymptomatic and are detected through routine postoperative clinic surveillance programmes with associated investigations. However, attendance at these clinics has a financial cost and may be associated with an increase in patient anxiety and dissatisfaction. The results of a remote follow-up system developed for selected patients are reported.
  
  
  METHODS
  A remote surveillance programme has been in place in our institution for over 9 years. Patients having elective and emergency treatment for colorectal cancer were enrolled. The timeliness of the investigation, detection of local recurrence and distant metastases and overall 5-year survival rates were determined. A cost review and patient satisfaction survey were performed.
  
  
  RESULTS
  The programme was suitable for over 900 patients who had received surgery for colorectal cancer between 2004 and 2012, representing some 50% of the total number of patients treated in this period. Of these, 811 (90%) had investigations carried out on time. Five-year survival rates were comparable with national data. Cost-minimization analysis demonstrated a financial saving of 63% and a 75% reduction in clinic appointments. High levels of overall patient satisfaction (97%) were noted with the programme.
  
  
  CONCLUSIONS
  A remote surveillance system after colorectal cancer surgery is a safe and cost-effective alternative to traditional clinic-based follow up and has high patient satisfaction.
authors: Department of Colorectal Surgery, Broomfield Hospital, Chelmsford, UK.
authors: A
authors: A
authors: Siddika
authors: Department of Colorectal Surgery, Broomfield Hospital, Chelmsford, UK.
authors: D
authors: D
authors: Tolia-Shah
authors: Department of Colorectal Surgery, Broomfield Hospital, Chelmsford, UK.
authors: T E
authors: TE
authors: Pearson
authors: Department of Colorectal Surgery, Broomfield Hospital, Chelmsford, UK.
authors: N G B
authors: NG
authors: Richardson
authors: Department of Colorectal Surgery, Broomfield Hospital, Chelmsford, UK.
authors: A H McL
authors: AH
authors: Ross
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D003082:Colectomy / Q000379:methods / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018579:Patient Selection; D015397:Program Evaluation; D011787:Quality of Health Care; D019114:Remote Consultation / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis
keywords: Colorectal cancer; distance surveillance; follow up; survival