Reconsidering follow-up care in gynaecologic oncology: A scoping review exploring alternative approaches

There is limited evidence supporting the effectiveness of current hospital-based follow-up after treatment for gynaecological cancers. Moreover, patients often report their aftercare needs are unmet. In an era of increasing pressure on healthcare resources - alongside a growing emphasis on patient-empowerment and appropriate care - it is time to reconsider current follow-up practices for gynaecological cancer survivors. This has led to a growing body of research exploring new approaches to follow-up care in gynaecologic oncology. In this scoping review, we aim to explore these alternative follow-up approaches and evaluate their effectiveness in comparison to current follow-up care.

The methodological framework for scoping studies by Arksey and O'Malley's was used, further guided by the PRISMA-ScR checklist. A literature search on follow-up care for gynaecological cancers was conducted in PubMed, EMBASE (Ovid) and Cochrane Library. Included studies employed a comparative method, allowing assessment of alternative approaches relative to current follow-up. Data were charted according to the TIDieR checklist and guide for better reporting of interventions.

Eighteen articles were included, identifying three categories of alternative follow-up strategies: nurse-led follow-up, reduced follow-up and patient-initiated follow-up. Across all categories, these approaches showed similar - and sometimes improved - effect on oncological outcomes, quality of life, and/or patient satisfaction, without increased costs and healthcare use.

Follow-up care can be delivered in alternative ways, without compromising on patient experiences or oncological safety. This offers the possibility of more cost-effective and resource-efficient healthcare. These findings support the feasibility of using alternative follow-up strategies in gynaecological oncological care.