Follow-up of gynecological cancer patients after treatment - the views of European experts in gynecologic oncology

Abstract

Objective: Follow-up after treatment for gynecological cancer demands large resources. There is a lack of evidence of efficacy. The aim of this survey was to explore follow-up routines and views on follow-up care among European experts in gynecological oncology.

Design: Web-based structured survey.

Setting: Survey distributed to members of the European Society of Gynecological Oncology (ESGO) and the Nordic Society of Gynecologic Oncology (NSGO).

Population: The study population comprised members of NSGO and ESGO.

Methods: An anonymous e-survey was sent with two additional reminders by e-mail through an electronic web-link to all members of both societies.

Main outcome measures: Surveillance routines. The clinical experts' evaluation of evidence and view of follow-up in hospitals vs. at general practitioners (GPs).

Results: The number of visits recommended by a majority of the responders was in line with current guidelines. The use of surveillance tests varied considerably. Significantly more responders from low economy countries preferred conventional hospital follow-up for all patients compared with responders from high economy countries, who considered follow-up by GPs adequate in low-risk groups (p < 0.001).

Conclusions: Follow-up routines after gynecological cancer vary in Europe. According to the majority of the responders of this survey targeting European experts in gynecological oncology, follow-up by GPs may be an option for low-risk patients. New follow-up routines should preferentially be based on prospective trials comparing conventional follow-up of gynecological cancer patients with alternative methods of care, assessing survival, detection of recurrence, and quality of life.