Article Text

Gynaecological cancer follow-up: national survey of current practice in the UK
  1. Simon Leeson1,
  2. Nick Stuart2,
  3. Yvonne Sylvestre3,
  4. Liz Hall1,
  5. Rhiannon Whitaker3
  1. 1Department of Obstetrics and Gynaecology, Betsi Cadwaladr University Health Board, Bangor, Gwynedd, UK
  2. 2School of Medical Sciences, Bangor University, Bangor, Gwynedd, UK
  3. 3North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, Gwynedd, UK
  1. Correspondence to Simon Leeson; simon.leeson{at}


Objective To establish a baseline of national practice for follow-up after treatment for gynaecological cancer.

Design Questionnaire survey.

Setting Gynaecological cancer centres and units.

Geographical location UK.

Participants Members of the British Gynaecological Cancer Society and the National Forum of Gynaecological Oncology Nurses.

Interventions A questionnaire survey.

Outcome measures To determine schedules of follow-up, who provides it and what routine testing is used for patients who have had previous gynaecological cancer.

Results A total of 117 responses were obtained; 115 (98%) reported hospital scheduled regular follow-up appointments. Two involved general practitioners. Follow-up was augmented or replaced by telephone follow-up in 29 responses (25%) and patient-initiated appointments in 38 responses (32%). A total of 80 (68%) cancer specialists also offered combined follow-up clinics with other specialties. Clinical examinations for hospital-based follow-up were mainly performed by doctors (67% for scheduled regular appointments and 63% for patient-initiated appointments) while telephone follow-up was provided in the majority by nurses (76%). Most respondents (76/117 (65%)) provided routine tests, of which 66/76 (87%) reported carrying out surveillance tests for ovarian cancer, 35/76 (46%) for cervical cancer, 8/76 (11%) for vulval cancer and 7/76 (9%) for endometrial cancer. Patients were usually discharged after 5 years (82/117 (70%)), whereas three (3%) were discharged after 4 years, nine (8%) after three years and one (1%) after 2 years.

Conclusions Practice varied but most used a standard hospital-based protocol of appointments for 5 years and routine tests were performed usually for women with ovarian cancer. A minority utilised nurse-led or telephone follow-up. General practitioners were rarely involved in routine care. A randomised study comparing various models of follow-up could be considered.

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