In a nutshell
This study reviewed the effect of follow-up programs on the survival of patients with colorectal cancer. Researchers suggested that intense follow-up programs do not improve the survival of these patients.
Colorectal cancer is a commonly diagnosed cancer in the US. Two in three patients will present with the possibly curable disease. Once treatment is completed, follow-up programs are necessary to detect recurrence (when cancer comes back). Follow-up programs usually include clinic visits, examinations, and tests (such as blood tests). More intensive follow-up may include more clinic visits and more tests. This can result in a faster detection of recurrences. However, it can also add more stress to the patients and higher costs to the health system.
It is still not clear if intensive follow-up programs improve the survival of colorectal cancer patients.
Methods & findings
This study reviewed 19 other studies. These studies included information about 13,216 patients with colorectal cancer who received treatment. Intense follow-up was compared to less intense follow-up in terms of outcomes.
Intensive follow-up made little to no difference to the overall survival. On average there were 24 fewer deaths per 1000 patients. No significant effect was seen in cancer-specific survival caused by intensive follow-up. There were 15 fewer cancer-associated deaths per 1000 patients.
Intensive follow-up had little to no effect on recurrence-free survival (time from treatment to recurrence). This was associated with 17 more recurrences per 1000 patients. Patients who received intensive follow-up were 1.98 times more likely to receive salvage surgery (treatment received after the failure of first treatment). This means 60 more cases of salvage surgery per 1000 patients. These patients also had a 41% improvement in the odds of having a recurrence without any symptoms.
Intensive follow-up increased the risk of complications such as bowel perforation by 7.3 times. The costs were also higher for intensive follow-up.
The bottom line
This study concluded that intensive follow-up of patients with colorectal cancer after surgery has little to no effect on their survival outcomes.
The fine print
This study was based on medical records. Some information might have been incomplete. This might affect the results.
Published By :
Cochrane database of systematic reviews
Sep 04, 2019
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