Randomized Trial of Long-Term Follow-Up for Early-Stage Breast Cancer: A Comparison of Family Physician Versus Specialist Care

Grunfeld, Eva; Levine, Mark; Julian, Jim A.; Coyle, Doug; Szechtman, Barbara; Mirsky, Doug; Verma, S.; Dent, Susan; Sawka, Carol; Pritchard, Kathleen I.; Ginsburg, David; Wood, Marjorie L.; Whelan, Timothy J.

doi:10.1200/jco.2005.03.2235

Cited by 476 publications

(418 citation statements)

References 54 publications

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“…Quality of life tools have been used to assess the impact of novel follow-up methods previously (Grunfeld et al, 1996(Grunfeld et al, , 2006Brown et al, 2002;Koinberg et al, 2004), but never specifically to screen for problems. Using such tools in this way should be done with care.…”

Section: Discussionmentioning

confidence: 99%

Automated telephone follow-up after breast cancer: an acceptability and feasibility pilot study

et al. 2008

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Traditional clinical follow-up after breast cancer is inefficient at detecting relapse and is poorly suited to detecting and ameliorating psychological problems. There is interest in developing more effective and efficient methods of follow-up. We report a prospective cohort study of the acceptability and feasibility of remote, automated telephone follow-up after breast cancer. Women with a history of breast cancer were approached at their annual follow-up visit. For participants, the follow-up questionnaire was administered on paper at baseline. In place of a clinic visit following year, the women completed the same questionnaire using an automated telephone system. All patients were given mammograms. A semi-structured interview was then conducted to assess the acceptability. The potential impact on clinic usage was assessed. In all, 110 of 121 women (91%) agreed to participate. Seventy-five patients (71%) completed follow-up using the new automated system 1 year later. Seventy-one of the 75 patients found the system easy to use. Forty-nine of the 75 (65.33%) liked the system and were happy to use it as their sole method of follow-up. A further 12% were happy to use it as part of their follow-up. In only 10.66% of participants were concerns raised which led to clinic attendance. Automated questionnaire-based telephone follow-up is acceptable to women and has the potential to reduce attendance at clinic. Further studies to validate this method further are planned.

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Section: Discussionmentioning

confidence: 99%

Automated telephone follow-up after breast cancer: an acceptability and feasibility pilot study

et al. 2008

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“…The three published RCTs examined follow-up for breast cancer 3,27 and colon cancer 30 (Table 1, part a). One of the breast cancer studies was a non-inferiority trial, 27 and the other incorporated a cost analysis.…”

Section: Primary Versus Secondary Carementioning

confidence: 99%

“…Five studies compared primary versus secondary care follow-up, 3,[27][28][29][30] but two were only reported in abstract form (a non-randomised study of patients who had undergone haematopoietic stem cell transplantation for malignant haematologic disorders 28 and a randomised controlled trial [RCT] of patients with cutaneous melanoma 29 ). The three published RCTs examined follow-up for breast cancer 3,27 and colon cancer 30 (Table 1, part a).…”

Section: Primary Versus Secondary Carementioning

confidence: 99%

Follow-up of cancer in primary care versus secondary care: systematic review

et al. 2009

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“…A recent study in Canada found that family physicians are able to monitor breast cancer patients for recurrence-related serious clinical events as well as cancer specialists, 9 suggesting that PCPs can take on the role of monitoring survivors for recurrence while providing ongoing preventive and primary care services. In contrast, whereas medical oncologists may provide some primary care services to patients, particularly during the active treatment phase, they prefer to spend their time on cancer-directed care.…”

Section: Introductionmentioning

confidence: 99%

Trends in Follow-up and Preventive Care for Colorectal Cancer Survivors

et al. 2008

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BACKGROUND: As cancer patients transition from treatment to survivorship, the responsibility of primary care providers (PCPs) versus oncology specialists is unclear.OBJECTIVES: To explore (1) physician types (PCPs versus oncology specialists) survivors visit during survivorship year 1, (2) preventive care received, (3) how preventive care receipt relates to physician types visited, and (4) trends in physician types visited and preventive care received over time. MEASUREMENTS: Using the SEER-Medicare database, we assessed the mean number of visits to different physician types, the percentage of survivors receiving preventive services, how receipt of preventive services related to physician types visited, and trends over time in physician visits and preventive care.RESULTS: There was a trend over time of increased visits to all physician types, which was statistically significant for oncology specialists and other physicians (p<.001) but not PCPs. The percentage of survivors receiving preventive services remained relatively stable across the 5 cohorts, except for an increase in bone densitometry (p<.05). Survivors who visited both a PCP and oncology specialist were most likely to receive each preventive care service (p<.05). CONCLUSIONS:Oncology specialist follow-up in survivorship year 1 is intensifying over time. Survivors not being followed-up by both PCPs and oncology specialists were less likely to receive preventive care. Clarifying the roles of PCPs and oncology specialists during followup can improve the quality of care for survivors.KEY WORDS: preventive care; cancer survivors; coordination of care.

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Randomized Trial of Long-Term Follow-Up for Early-Stage Breast Cancer: A Comparison of Family Physician Versus Specialist Care

Abstract: Breast cancer patients can be offered follow-up by their family physician without concern that important recurrence-related SCEs will occur more frequently or that HRQL will be negatively affected.

Cited by 476 publications

References 54 publications

Automated telephone follow-up after breast cancer: an acceptability and feasibility pilot study

Automated telephone follow-up after breast cancer: an acceptability and feasibility pilot study

Follow-up of cancer in primary care versus secondary care: systematic review

Trends in Follow-up and Preventive Care for Colorectal Cancer Survivors

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