Follow-up practice in endometrial cancer and the association with patient and hospital characteristics: A study from the population-based PROFILES registry

K.A.H. Nicolaije, N.P.M. Ezendam, M.C. Vos, D. Boll, J.M.A. Pijnenborg, R. Kruitwagen, M.L. Lybeert, L.V. van de Poll-Franse

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32 Citations (Scopus)

Abstract

Objective
To examine to what extent endometrial cancer survivors experienced follow-up according to the Dutch national guidelines, and to identify associations between follow-up care consumption and socio-demographic and clinical characteristics, Health-Related Quality of Life (HRQL), and worry (including fear of recurrence). Patients' preferences with the received follow-up care were also evaluated.
Methods
All patients diagnosed with endometrial cancer FIGO stages I–II between 1999 and 2007, registered in the Eindhoven Cancer Registry (ECR), received a questionnaire including patients' follow-up care consumption, preferences regarding the follow-up schedule, HRQL (SF36 and EORTC-QLQ-EN24), and worry (IOCv2).
Results
742 (77%) endometrial cancer survivors returned a completed questionnaire. Overall, 19% reported receiving more follow-up visits than recommended by the guidelines. Overconsumption of follow-up care was lowest in follow-up year 1 (13%), and highest in follow-up years 6–10 (27%). In addition, overconsumption was associated with having a comorbid condition, a higher score on the worry subscale, and hospital of treatment. Most patients (83%) felt comfortable with their follow-up schedule. Patients in follow-up years 6–10 felt least comfortable (69%).
Conclusion
Follow-up frequency was higher than recommended in a large group of endometrial cancer survivors, mainly in follow-up years 6–10. Moreover, a substantial variation in follow-up practice was observed between the different hospitals. Despite limited evidence to support the use of intensive follow-up schedules, the current study suggests that intensive routine follow-up after endometrial cancer continues to be standard practice. Possibly, patients should be better informed in order to reduce overconsumption and worry.
Highlights
► 19% of endometrial cancer survivors received more follow-up than recommended by the guidelines, mainly in follow-up years 6–10 (27%).
► Although most survivors felt comfortable with their follow-up schedule, survivors in follow-up years 6–10 more often preferred no follow-up.
► Factors associated with more overconsumption of follow-up care were follow-up year, hospital of treatment, comorbidity, and worry.
Keywords: Endometrial cancer, Cancer survivors, Follow-up frequency, Follow-up care consumption, Hospital variation, Health-Related Quality of Life
Original languageEnglish
Pages (from-to)324-331
JournalGynecologic Oncology
Volume129
Issue number2
DOIs
Publication statusPublished - 2013

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