title: Trans-sectoral care in patients with colorectal cancer: Protocol of the randomized controlled multi-center trial Supportive Cancer Care Networkers (SCAN).
abstract: BACKGROUND
  Managing therapy-related side-effects and improving health-related quality of life in patients with colorectal cancer is still challenging. The need for an effective management of adverse events and unmet supportive care needs have been widely discussed. In the past decade, interventions by nursing staff gained more and more importance. Evidence suggests that a majority of patients even in early stages of the disease experience substantial impairments potentially resulting in diminished therapy adherence as well as impaired quality of life. However, evidence for the effectiveness of nurse-led interventions on symptom management and quality of life is still very limited. This especially applies to care transitions between different inpatient and outpatient health care providers throughout the course of treatment and aftercare.
  
  
  METHODS
  Supportive Cancer Care Networkers (SCAN) is a prospective randomized controlled trial conducted in eight large and middle-sized German cancer centers and municipal hospitals. The target population is adults with colorectal cancer UICC I-III after initial R-0 resection scheduled for adjuvant chemotherapy or guideline-based aftercare only. 370 patients will be randomly assigned to either intervention or control group. Patients in the intervention group will receive an additional support by specialized oncology nurses for eight weeks after discharge from hospital by telephone, consisting of symptom monitoring, counselling on self-assessment and self-management and dealing with individual resources for coping and psychosocial well-being. The primary endpoint will be health-related quality of life (HRQoL) at eight weeks after discharge from the initial treating hospital.
  
  
  CONCLUSIONS
  The presented SCAN trial is to provide information that will be useful to advance our understanding of complex interdependencies between symptom severity, supportive care needs, functioning and the risk for diminished HRQoL. Most importantly, these patient-reported outcomes are not fully implemented in today's clinical routine practice potentially resulting in therapy cessations and lower chemotherapy treatment rates for colorectal cancer especially in older patients.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier NCT01651832.
authors.affiliation: Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany. alexander.bauer@medizin.uni-halle.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Bauer
authors.affiliation: Department of Radiation Oncology, University Hospital Halle, Ernst-Grube-Strasse 40, D-06120, Halle, Germany. dirk.vordermark@uk-halle.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Albert Einstein Allee 23, Ulm, D-89081, Germany. thomas.seufferlein@uniklinik-ulm.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Seufferlein
authors.affiliation: University Hospital Halle, Clinic for Internal Medicine IV, Ernst-Grube-Strasse 40, D-06120, Halle, Germany. hans-joachim.schmoll@uk-halle.de.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Schmoll
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital, Ernst-Grube-Strasse 40, D-06120, Halle, Germany. henning.dralle@uk-halle.de.
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
authors.affiliation: Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Rehabilitation Medicine, Magdeburger Strasse 8, D-06112, Halle, Germany. wilfried.mau@medizin.uni-halle.de.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Mau
authors.affiliation: Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Medical Epidemiology, Biostatistics and Informatics, Magdeburger Strasse 8, D-06112, Halle, Germany. susanne.unverzagt@medizin.uni-halle.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Unverzagt
authors.affiliation: Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany. stephanie.boese@medizin.uni-halle.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Boese
authors.affiliation: Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany. eva-maria.fach@medizin.uni-halle.de.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Fach
authors.affiliation: Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Magdeburger Strasse 8, D-06112, Halle, Germany. margarete.landenberger@medizin.uni-halle.de.
authors.forename: Margarete
authors.initials: M
authors.lastname: Landenberger
mesh_terms: D000328:Adult; D000359:Aftercare / Q000458:organization & administration / Q000523:psychology; D000368:Aged; D015179:Colorectal Neoplasms / Q000451:nursing* / Q000523:psychology / Q000628:therapy; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009859:Oncology Nursing / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D012944:Social Support