A national, prospective observational study of first recurrence after primary treatment for gynecological cancer in Norway

Abstract

A majority of patients experienced symptomatic recurrence, but many patients failed to make an appointment earlier than scheduled. Most first recurrences occurred within two years of primary treatment; the mean annual incidence rate for years 3-5 after primary treatment was <7%. New models for follow up of gynecological cancer patients could be considered.

Gynecological cancer patients’ attitudes toward follow‐up care after cancer treatment: Do preferences reflect patients’ experience? A cross‐sectional questionnaire study

“…The patients in our study thought that the main reason for attending follow‐up is to detect possible recurrence, which is in line with most previous studies . However, it has been shown that recurrent gynecological cancer is often detected by the patient herself between scheduled visits because of symptoms . Thus, many patients seem to have an unrealistic view of the importance of gynecological examination, which overshadowed the other aspects of follow‐up in our study (such as psychosocial support, follow‐up of late effects after treatment and getting information about the disease).…”

“…In several studies, GPs have reported broad experience in providing follow‐up care to cancer patients, and they have acknowledged their responsibility regarding this task . Moreover, there is little empirical evidence that the current hospital‐based follow‐up regimen benefits gynecological cancer patients in terms of early detection of recurrence, quality of life or survival . However, if the follow‐up regimens are to be changed, it is important to assess the preferences and understand the needs of cancer patients in order to design patient‐centered follow‐up care.…”

Electronic patient‐reported outcomes to monitor symptoms after gynecological cancer treatment

“…Cancer treatment may cause symptoms that contribute to patients’ distress, interfere with physical functioning and daily activities, and ultimately increase health care service utilization. Symptoms may also represent cancer recurrence, but many patients choose to wait until the next scheduled visit rather than altering their health care provider, thereby delaying treatment . Further, studies show that clinicians are unaware of up to half of patients’ symptoms .…”

“…Would patients with gynecological cancer benefit from including ePROs in their follow‐up? We know from several studies that the majority of patients with gynecological cancer have a symptomatic recurrence and that nearly half of symptomatic patients fail to make an appointment before their next scheduled follow‐up visit . Thus, patient education on signs and symptoms is a critical component of post‐treatment care and may lead to the early detection of recurrent disease.…”

“…We know from several studies that the majority of patients with gynecological cancer have a symptomatic recurrence 1 and that nearly half of symptomatic patients fail to make an appointment before their next scheduled follow-up visit. 1 Thus, patient education on signs and symptoms is a critical component of post-treatment care and may lead to the early detection of recurrent disease. To date, only two non-recruiting studies involving gynecological cancer patients and aiming to use ePROs to report symptoms are registered in clinicaltrials.gov (NCT03850912 and NCT03838861).…”