Data from: Gynaecological cancer follow-up: national survey of current practice in the UK

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 (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 care was provided in the majority by nurses (76%). Most respondents provided routine tests (76/117 (65%)), from 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. Usually patients were discharged after five years (82/117 (70%)), whereas three (3%) were discharged after four years, nine (8%) after three and one (1%) after two years. Conclusions: Practice varied but most used a standard hospital based protocol of appointments for five 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.

研究目标：建立妇科肿瘤治疗后随访的全国性实践基线。研究设计：问卷调查法。研究场景：妇科肿瘤诊疗中心与病区。地理范围：英国。研究对象：英国妇科肿瘤学会（British Gynaecological Cancer Society）会员及妇科肿瘤护理全国论坛成员。干预措施：问卷调查。结局指标：明确既往罹患妇科肿瘤患者的随访方案、随访实施主体及常规检测项目。研究结果：共回收有效问卷117份；其中115份（98%）报告采用医院安排的定期随访门诊。有2份方案涉及全科医师（General Practitioners）参与随访。29份（25%）采用电话随访补充或替代常规门诊随访，38份（32%）由患者主动发起随访预约。共计80份（68%）的肿瘤专科医师还开设了与其他专科联合的随访门诊。医院常规随访的临床检查主要由医师完成（定期预约随访中占比67%，患者主动发起的随访中占比63%），而电话随访服务则多数由护理人员提供（占比76%）。多数受访者开展常规检测项目（76/117，65%），其中66/76（87%）报告针对卵巢癌患者开展监测性检测，35/76（46%）针对宫颈癌，8/76（11%）针对外阴癌，7/76（9%）针对子宫内膜癌。通常患者在随访满5年后终止随访（82/117，70%），另有3份（3%）在4年后终止随访，9份（8%）在3年后终止随访，1份（1%）在2年后终止随访。研究结论：当前妇科肿瘤随访实践存在差异，但多数采用医院主导的5年定期随访方案，常规检测多针对卵巢癌患者。少数实践采用护理主导或电话随访模式。全科医师极少参与常规随访工作。未来可考虑开展随机对照研究，对比不同随访模型的临床效果。