Cochrane · systematic review · CD012425
Follow‐up strategies following completion of primary cancer treatment in adult cancer survivors
Høeg, BL, Bidstrup, PE, Karlsen, RV, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Effective Practice and Organisation of CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
18
current version
GRADE rated
15
No studies
3
Included studies
NR
No studies 3 · 16.7%Ungraded 0 · 0%Very low 10 · 55.6%Low 2 · 11.1%Moderate 2 · 11.1%High 1 · 5.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Non‐specialist‐led versus specialist‐led follow‐up after primary cancer treatment
Population: adult cancer survivors from the following cancer sites: breast, colon, colorectal, endometrial, ovarian, cervical, melanoma and oesophageal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Non‐specialist‐led vs specialist‐led follow‐up after primary cancer treatment | HR 1.21 [0.68, 2.15] | 603 participants | Very low Downgraded: imprecision, indirectness |
Time to detection of recurrence Non‐specialist‐led vs specialist‐led follow‐up after primary cancer treatment | no estimate extracted | 1691 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Health‐related quality of life, (at 12 months' Non‐specialist‐led vs specialist‐led follow‐up after primary cancer treatment | MD 1.06 | 605 participants | Low Downgraded: imprecision, inconsistency |
Anxiety (at 12 months' Non‐specialist‐led vs specialist‐led follow‐up after primary cancer treatment | MD 0.03 | 1266 participants | Moderate Downgraded: inconsistency, indirectness |
Depression (at 12 months) HADS‐Depression subscale (higher scores indicate worse depression) Non‐specialist‐led vs specialist‐led follow‐up after primary cancer treatment | MD 0.03 | 1266 participants | High |
Cost Non‐specialist‐led vs specialist‐led follow‐up after primary cancer treatment | no estimate extracted | 1756 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Less intensive versus more intensive follow‐up after primary cancer treatment
Population: adult cancer survivors from the following cancer sites: breast, colorectal, head‐and‐neck, Hodgkin lymphoma, melanoma, non‐small cell lung cancer and testicular cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Less intensive vs more intensive follow‐up after primary cancer treatment | HR 1.05 [0.96, 1.14] | 10726 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to detection of recurrence Less intensive vs more intensive follow‐up after primary cancer treatment | HR 0.85 [0.79, 0.92] | 11276 participants | Moderate Downgraded: indirectness |
Health‐related quality of life Less intensive vs more intensive follow‐up after primary cancer treatment | no estimate extracted | 2742 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Anxiety Less intensive vs more intensive follow‐up after primary cancer treatment | no estimate extracted | 180 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Depression Less intensive vs more intensive follow‐up after primary cancer treatment | no estimate extracted | NR | No studies |
Cost Less intensive vs more intensive follow‐up after primary cancer treatment | no estimate extracted | 1412 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans versus usual care
Population: adult cancer survivors from the following cancer sites: breast, colorectal, endometrial, ovarian and prostate cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans vs usual care | no estimate extracted | NR | No studies |
Time‐to‐ detection of recurrence Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans vs usual care | no estimate extracted | NR | No studies |
Health‐related quality of life, (HRQoL) Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans vs usual care | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Anxiety Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans vs usual care | no estimate extracted | NR | Very low Downgraded: imprecision, inconsistency, indirectness |
Depression Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans vs usual care | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Cost Follow‐up integrating additional patient symptom education or monitoring, or survivorship care plans vs usual care | no estimate extracted | NR | Very low Downgraded: imprecision, inconsistency, indirectness |