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Annals of Oncology 14:400-405, 2003
© 2003 European Society for Medical Oncology

Original Paper

Cancer physicians’ attitudes toward colorectal cancer follow-up

C. C. Earle1,+, E. Grunfeld2,3, D. Coyle3, M. C. Cripps2 and H. S. Stern2,4

1 Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; 2 Ottawa Regional Cancer Centre and Division of Medical Oncology, University of Ottawa, Ottawa; 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa; 4 Department of Surgery, University of Ottawa, Ottawa, Canada

Received 13 June 2002; revised 11 September 2002; accepted 2 October 2002

Background:

The optimal follow-up strategy for colorectal cancer is unknown.

Materials and methods:

We surveyed all Canadian radiation oncologists, medical oncologists and surgeons specializing in colorectal cancer to assess their recommendations for follow-up after potentially curative treatment, the beliefs and attitudes underlying these practices, and the cost implications of different follow-up strategies.

Results:

One hundred and sixty practitioners (58%) returned completed surveys. Most recommended clinical assessments every 3–4 months in the first 2 years including carcino-embryonic antigen testing, gradually decreasing in frequency over 5 years. Ninety per cent recommend a surveillance colonoscopy in the first year. The majority felt that specialist involvement in follow-up was important because of the increased opportunities for patients to contribute to research (76%) and teaching (73%). About half felt that specialists were more efficient at providing follow-up than primary care physicians, but these same physicians recommended significantly longer and more expensive follow-up routines on average than others. Primary care physicians were felt to be important allies, especially in managing the psychosocial concerns of patients.

Conclusions:

Surveillance practices are generally in keeping with published recommendations. Most specialists feel that they should remain involved in follow-up, but this may result in increased resource utilization.

Key words: colorectal cancer, costs, follow-up, physician survey


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