References
Patient satisfaction with patient-led follow-up for endometrial cancer
Abstract
Background:
The 5-year hospital follow-up after treatment for endometrial cancer can increase anxiety for patients and not directly pick up cancer recurrence.
Aims:
The aim of this study was to assess patient satisfaction with a patient-led follow-up and identify cancer recurrence.
Methods:
This study population was 104 women with early uterine cancer who had undergone surgery. They were given information regarding symptoms suspicious for recurrence and started on a patient-led follow-up, which included a yearly phone call from the nursing team, and a questionnaire was completed.
Findings:
Most patients (92%) scored ≥9 on the 10-point satisfaction survey. Nine women came back to the clinic for pain or bleeding. There was no recurrence of cancer in this study population.
Conclusion:
Patients are satisfied with a patient-led, telephone follow-up. This data has influenced a change in the regional Cancer Alliance guidance on cancer follow-up emphasising risk stratification.
The incidence of uterine cancer is increasing (Lortet-Tieulent et al, 2018). The most common cancer is hormone-responsive (type 1) endometrioid adenocarcinoma. In the UK, the follow-up practice after treatment for uterine cancer is to review the patients in clinic regularly for 5 years. However, the 5-year survival for stage 1A, grade 1 endometrial cancers is 95% (SEER, 2020) and most women will not have a recurrence. Furthermore, a recurrence is not usually diagnosed at routine follow-up but brought to medical attention because of symptoms (Salani et al, 2011; Jeppesen et al, 2017). Anecdotally, cancer patients in general experience anxiety when attending follow-up visits.
There is a drive from various bodies, including the British Gynaecological Cancer Society (BGCS), to consider other means of follow-up for cancers with a good prognosis, which are safe and acceptable to patients. Any reduction in follow-up may help reduce anxiety for a significant number of women. BGCS guidelines state ‘the data is not robust enough to allow us to calculate the utility of follow-up with precision but women with low risk endometrial cancer should be reassured that failure to attend at a follow-up clinic is extremely unlikely to be detrimental to their survival prospects’ (Sundar et al, 2017). This statement supports the suggestion that a clinical follow-up is perhaps not necessary to diagnose recurrence in low-grade, early-stage cancers that are at a low risk of this. Furthermore, many studies have been done to show an intensive surveillance protocol seems to have no significant impact on the outcome of patients with stage 1 endometrial cancer (Gadducci et al, 2000).
Register now to continue reading
Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Limited access to clinical or professional articles
-
Unlimited access to the latest news, blogs and video content