[Routine follow up after treatment for gynecological cancer]

Cancer patients are traditionally given follow-up. An earlier diagnosis of recurrent disease is thought to improve chances for curative treatment. The aim of this study was to investigate the approach to routine follow-up after treatment for gynecological cancer.

A questionnaire was sent to all gynaecologic departments in Norway.

The number of examinations offered varies from eight to 15 during the first five-year period after primary treatment. Most departments offer four examinations during the first year, two during the second and third years, and one yearly thereafter. There are variations in the routine use of additional tests. Most departments use cytological tests for vulvar, cervical and uterine cancer patients. Chest roentgenography is used more frequently among cervical and uterine cancer patients compared with vulvar and ovarian cancer patients. For ovarian cancer patients, the use of ultrasound investigations is frequent; more than 90% of the departments use blood tests, CA-125 being the most common.

There are large variations in follow-up procedures. Advantages and disadvantages with routine examinations are discussed. Most recurrences are detected when they cause symptoms, most often in the interval between visits, and their effect on survival is uncertain. The protocols applied seem to be in line with the pattern of recurrence. Controlled trials investigating alternative protocols in relation to sensitivity, survival, cost and quality of life are important, especially for patients for whom potentially curative treatment is available.