Variation in routine follow-up care after curative treatment for head-and-neck cancer: a population-based study in Ontario

[摘要] BackgroundThe actual practices of routine follow-up after curative treatment for head-and-neck cancer are unknown, and existing guidelines are not evidence-based. MethodsThis retrospective population-based study used administrative data to describe 5 years of routine follow-up care in 3975 head-and-neck cancer patients diagnosed between 2007 and 2012 in Ontario. ResultsThe mean number of visits per year declined during the follow-up period (from 7.8 to 1.9,p< 0.001). The proportion of patients receiving visits in concordance with guidelines ranged from 80% to 45% depending on the follow-up year. In at least 50% of patients, 1 head, neck, or chest imaging test was performed in the first follow-up year; that proportion subsequently declined ( p< 0.001). Factors associated with follow-up practices included comorbidity, tumour site, treatment, geographic region, and physician specialty ( p< 0.05). ConclusionsGiven current practice variation and the absence of an evidence-based standard, the challenge in identifying a single optimal follow-up strategy might be better addressed with a harmonized approach to providing individualized follow-up care.

[学科分类] 肿瘤学

[关键词] Head-;-neck cancer;routine follow-up;practice variation;imaging