Open AccessVariation in Routine Follow-Up Care After Curative Treatment for Head-and-Neck Cancer: A Population-Based Study in Ontario
Author(s) -
Kelly Brennan,
Stephen F. Hall,
Timothy Owen,
Rebecca Griffiths,
Yingwei Peng
Publication year - 2018
Publication title -
current oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.053
H-Index - 51
eISSN - 1718-7729
pISSN - 1198-0052
DOI - 10.3747/co.25.3892
Subject(s) - medicine , concordance , head and neck cancer , head and neck , specialty , comorbidity , retrospective cohort study , cancer , population , family medicine , general surgery , surgery , environmental health
Background: The actual practices of routine follow-up after curative treatment for head-and-neck cancer are unknown, and existing guidelines are not evidence-based. Methods: This 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. Results: The 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). Conclusions: Given 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.