What is the most effective follow-up model for lung cancer patients? A systematic review

In the U.K. more than 40,000 people are diagnosed with lung cancer every year and an estimated 65,000 people are living with lung cancer. The most effective follow-up strategy for these patients is undetermined. This article reports a systematic review of studies comparing different follow-up strategies for patients with lung cancer.

We searched Medline, Premedline, Embase, Cochrane Library, Cinahl, BNI, Psychinfo, Amed, Web of Science (SCI & SSCI), and Biomed Central and included any original study published in English comparing one type of follow-up strategy to another in patients with lung cancer who had received treatment with curative or palliative intent and/or best supportive care. Studies were included if there were 50 patients or more per follow-up group.

Of the four included studies that compared different follow-up strategies in patients with lung cancer, one was a randomized controlled trial and three were retrospective. The studies all examined different follow-up strategies and tended to be marked by various limitations. No formal data synthesis was therefore possible. However, in one article there was some evidence that regular review was associated with less emergency-department crisis attendances than symptom-generated review.

The included studies were marked by a number of methodological compromises. On the basis of the reported body of evidence it is therefore not possible to make any firm conclusions about the most effective follow-up strategy but the review has identified a need for urgent research into all aspects of follow-up.