General practitioner-led vs surgeon-led colon cancer survivorship care: a randomized clinical trial

The randomized controlled I CARE (Improving Care After colon canceR treatment in the Netherlands) trial evaluated the impact of general practitioner-led vs surgeon-led survivorship care on quality of life (QoL) in colorectal cancer survivors, alongside the effect of the eHealth application Oncokompas. The trial was conducted in 8 hospitals and 225 general practices across the Netherlands, including 303 patients who underwent surgery for stage I-III colon cancer or rectosigmoid carcinoma. Patients were randomly assigned into 4 groups: surgeon-led care, surgeon-led care with Oncokompas, general practitioner-led care, and general practitioner-led care with Oncokompas. QoL was assessed at multiple time points over 60 months. At 60 months, no clinically relevant differences in QoL were found between general practitioner-led and surgeon-led care (difference in summary score = -0.5, 95% CI = -1.6 to 0.5) or with Oncokompas (difference = 0.8, 95% CI = 0.0 to 1.6). In conclusion, neither general practitioner involvement nor access to Oncokompas led to clinically relevant improvements in long-term QoL. Survivorship care can be tailored to preferences. Netherlands Trial Register; NTR4860.