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A systematic review of patient perspectives on surveillance after colorectal cancer treatment

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A Correction to this article was published on 27 June 2018

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Abstract

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.

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Change history

  • 27 June 2018

    The original version of this article unfortunately contained a mistake. The online supplementary files are missing. The complete version of online supplementary materials are published with this erratum.

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Correspondence to George J. Chang.

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Funding sources

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.

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The authors declare that they have no conflict of interest.

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Berian, J.R..., Cuddy, A., Francescatti, A.B. et al. A systematic review of patient perspectives on surveillance after colorectal cancer treatment. J Cancer Surviv 11, 542–552 (2017). https://doi.org/10.1007/s11764-017-0623-2

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