Survivorship care for early‐stage colorectal cancer: a national survey of general surgeons and colorectal surgeons

• Published in: Colorectal disease Vol. 20; no. 11; pp. 996 - 1003
• Main Authors: Choi, Y., Huntley, J. H., Efron, J. E., Sato, K., Marohn, M. R., Pollack, C. E.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2018
• Subjects: Cancer survivorship; Colon; Colorectal cancer; Colorectal carcinoma; Endoscopy; Medical personnel; Patients; Primary care; Rectum; Surgeons; Survival; colorectal cancer; Cancer survivorship
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.14321

Aim Few data are available on the optimal long‐term care of early‐stage colorectal cancer survivors, termed survivorship care. We aimed to investigate current practice in the management of patients following treatment for early‐stage colorectal cancer. Method We performed an internet survey of members of the American Society for Colon and Rectal Surgeons about several aspects of long‐term care, including allocation of clinician responsibility, challenges with transitions to primary care physicians (PCPs), long‐term care plan provision and recommended surgical follow‐up duration. Results Overall, 251 surgeons responded. Surgeons reported taking primary responsibility for managing adverse surgical effects (93.2%) and surveillance testing (imaging and laboratories 68.6%, endoscopy 82.4%). Barriers to PCP handoffs included patient preference for surgical follow‐up (endorsed by 76.6%) and inadequate communication with PCPs (endorsed by 36.9%). Approximately one‐third of surgeons routinely provide survivorship care plans to PCPs; surgeons who received formal survivorship training were more likely to do so compared to those without such training (OR 3.29, 95% CI 1.57, 6.92). Although only 20.4% of surgeons follow their patients beyond 5 years, individuals in practice longer were more likely to continue long‐term follow‐up than those with ≤ 10 years of experience. Conclusions This is the largest survey of surgeons regarding long‐term management for early‐stage colorectal cancer and highlights the potential for improved coordination with PCPs and increased implementation of survivorship care plans.