The process and outcomes of a nurse-led colorectal cancer follow-up clinic

• Published in: Colorectal disease Vol. 14; no. 5; pp. e245 - e249
• Main Authors: McFarlane, K., Dixon, L., Wakeman, C. J., Robertson, G. M., Eglinton, T. W., Frizelle, F. A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2012
• Subjects: Adult; Aged; Aged, 80 and over; Ambulatory Care - methods; Colorectal cancer; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Colorectal Neoplasms - therapy; Critical Pathways; Delivery of Health Care - methods; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - therapy; nurse-led follow-up; outcome; Outcome and Process Assessment (Health Care); Practice Patterns, Nurses; recurrence; Referral and Consultation; Young Adult
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2011.02923.x

Aim  Evidence suggests that follow‐up after colorectal cancer improves survival. Colorectal cancer is so common that patient follow‐up can overwhelm a service, affecting the ability to see new referrals and reassess patients seen previously who have new symptoms. In order to cope with this demand a nurse‐led follow‐up service was started in 2004. We aimed to review the results of a nurse‐led colorectal cancer follow‐up clinic. Method  Between 1 December 2004 and 31 January 2011, patients who underwent resection for colorectal cancer were followed up by a nurse specialist according to a protocol determined by the colorectal surgeons in the unit. All patient details were recorded prospectively in a purpose designed database. Results  Nine hundred and fifty patients were followed up over 7 years. Some 368 patients were discharged from the follow‐up programme, 474 patients remain actively involved in the programme and 108 patients died. Of the patients discharged from the follow‐up scheme 269 (73%) were discharged to their general practitioner free of disease after 5 years. Of the 108 who patients died, 98 were as a result of colorectal cancer. Twenty patients (2.1%) were identified with local (peri‐anastomotic) disease recurrence and 93 patients (9.8%) were found to have developed distant metastatic disease. Of these, 65 patients (6.8%) were referred for palliative care and 28 (2.9%) had surgery for focal metastatic disease of whom 18 were still alive at the time of this analysis. Conclusion  This paper shows that a nurse‐led clinic for colorectal cancer follow‐up can achieve satisfactory results with detection rates of recurrent or metastatic disease comparable to consultant follow‐up. A nurse‐led clinic provides the benefits of follow‐up without overwhelming the consultant colorectal surgical clinic practice.