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Follow-up after colorectal cancer: current practice in The Netherlands
D J Bruinvels1, A M Stiggelbout, M P Klaassen
1Medical Decision Making Unit, University Hospital Leiden, Netherlands.
Objective:
To assess the current practice of follow-up after operations for colorectal cancer in The Netherlands in comparison with other countries.
Design:
Postal survey.
Setting:
All surgical departments in The Netherlands.
Main Outcome Measures:
Attitudes of surgeons towards detection and treatment of recurrences after colorectal cancer.
Results:
Of the 139 questionnaires sent out, 136 (98%) were returned. History taking, physical examination, and colonoscopy for local recurrence and metachronous tumours were used by 90% of the hospitals. Attitudes towards screening for hepatic and pulmonary metastases and regional recurrence varied considerably between hospitals. Similar findings were found in seven surveys from other countries.
Conclusion:
There is no consensus among surgeons regarding the follow-up of patients with colorectal cancer. Randomised controlled trials comparing different follow-up strategies and cost-effectiveness analyses are needed to identify groups of patients that will benefit most from follow-up. Identification of these patients may lead to more agreement between surgeons.