Follow-Up Strategies in Colorectal Cancer: What Do Patients Prefer?

Abstract

Background: Increasing numbers of colorectal cancer patients and healthcare constraints mean novel follow-up strategies need to be considered. The optimal method of follow-up is unclear; however, a patient-tailored model could reduce costs, improve patient experience, and improve overall health. The aim was to explore patients' perspectives on current and alternative follow-up strategies and barriers to follow-up, to create a patient-led framework to guide further development of colorectal cancer follow-up.

Methods: A qualitative study was conducted using semi-structured interviews with patients who underwent curative-intent colorectal cancer surgery. Thirteen participants (seven women, five Māori, age range 41-86 years) were recruited in Northland. Thematic analysis was performed using the Braun and Clarke method.

Results: Patients were mostly satisfied and experienced positivity and reassurance around follow-up visits. Patients were open to alternative methods of follow-up. Benefits of remote follow-up included convenience, familiarity with prior experience, and resource-saving, while reservations included lack of physical contact, inability to use technology, and higher thresholds to raise concerns. Reservations of GP follow-up included lack of continuity, feeling rushed, misdiagnosis, and difficulty accessing care. Barriers to follow-up included inaccessibility, disability, travel, and obligations, while enablers included social support and access to transport.

Conclusion: Colorectal cancer patients have positive experiences of follow-up, with alternative modalities for follow-up being feasible. While barriers need to be addressed, some could be overcome by a patient-tailored model of follow-up.