Abstract

Background: Specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors’ needs. Alternative models informed by survivors’ preferences are urgently needed. It is unknown if follow-up preferences differ by cancer type. We conducted the first study to assess British cancer survivors’ follow-up preferences, and the first anywhere to compare preferences of survivors from different cancers.
Methods: A discrete choice experiment questionnaire was mailed to 1,201 adults in Northeast Scotland surviving melanoma, breast, prostate or colorectal cancer. Preferences and trade-offs for attributes of cancer follow-up were explored, overall and by cancer site.
Results: 668 (56.6%) recipients (132 melanoma; 213 breast; 158 prostate; 165 colorectal) responded. Cancer survivors had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up. However, cancer survivors appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling. Longer appointments were also valued. Telephone and web-based follow-up and group counselling, were not considered desirable. Survivors of colorectal cancer and melanoma would see any alternative provider for greater continuity, whereas breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a general practitioner.
Conclusion: Cancer survivors may accept non-consultant follow-up if compensated with changes elsewhere. Care continuity was sufficient compensation for most cancers. Given practicalities, costs, and the potential to develop continuous care, specialist nurse-led cancer follow-up may be attractive.

Original languageEnglish
Pages (from-to)1495-1503
Number of pages9
JournalBritish Journal of Cancer
Volume115
Issue number12
Early online date1 Nov 2016
DOIs
Publication statusPublished - 6 Dec 2016

Keywords

  • cancer
  • survivorship
  • follow-up
  • primary care
  • discrete choice experiment
  • patient preferences

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