Purpose: Surveillance after colorectal cancer (CRC) treatment is routine, but intensive follow-up may offer little-to-no overall survival benefit. Given the growing population of CRC survivors, we aimed to systematically evaluate the literature for the patient perspective on two questions: (1) How do CRC patients perceive routine surveillance following curative treatment and what do they expect to gain from their surveillance testing or visits? (2) Which providers (specialists, nursing, primary care) are preferred by CRC survivors to guide post-treatment surveillance? Methods: Systematic searches of PubMed MEDLINE, Embase, the CENTRAL Register of Controlled Trials, CINAHL, and PsycINFO were conducted. Studies were screened for inclusion by two reviewers, with discrepancies adjudicated by a third reviewer. Data were abstracted and evaluated utilizing validated reporting tools (CONSORT, STROBE, CASP) appropriate to study design. Results: Citations (3691) were screened, 91 full-text articles reviewed, and 23 studies included in the final review: 15 quantitative and 8 qualitative. Overall, 12 studies indicated CRC patients perceive routine surveillance positively, expecting to gain reassurance of continued disease suppression. Negative perceptions described in six studies included anxiety and dissatisfaction related to quality of life or psychosocial issues during follow-up. Although 5 studies supported specialist-led care, 9 studies indicated patient willingness to have follow-up with non-specialist providers (primary care or nursing). Conclusions: Patients’ perceptions of follow-up after CRC are predominantly positive, although unmet needs included psychosocial support and quality of life. Implications for Cancer Survivors:: Survivors perceived follow-up as reassuring, however, surveillance care should be more informative and focused on survivor-specific needs.
Bibliographical noteFunding Information:
This work was supported, in part, by the Patient-Centered Outcomes Research Institute (PCORI), Award [CE13–04-6855, GJC]. The content is the responsibility of the authors and does not represent the views of PCORI, its Board of Governors, or the Methodology Committee. This work was also supported, in part, by the National Cancer Institute of the National Institutes of Health under the Award Number(s) UG1CA189823 to the Alliance for Clinical Trials in Oncology NCORP Research Base (Jan C. Buckner, M.D., contact PI). The content is the responsibility of the authors and does not represent the views of the National Institutes of Health. This work was also supported, in part, by a grant from The University of Texas MD Anderson Cancer Center’s Duncan Family Institute for Cancer Prevention and Risk Assessment. Dr. Berian’s position is funded by the John A. Hartford Foundation and American College of Surgeons.
© 2017, Springer Science+Business Media New York.
- Colorectal cancer surveillance
- Follow-up care
- Patient-centered care