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Does the frequency of routine follow-up after curative treatment for head-and-neck cancer affect survival?

Hall SF, Owen T, Griffiths RJ, Brennan K. Curr Oncol. 2019; 26(5):295-306. Epub 2019 Oct 1.

Background — Routine follow-up is a cornerstone of oncology practice but evidence is lacking to support most aspects. Our objective was to investigate the relationship between frequency of routine follow-up and survival.

Methods — A population-based study using electronic health-care data based on 5310 patients from Ontario diagnosed with squamous cell head and neck cancer between 2007 and 2012. Treatments included surgery (24.6%), radiotherapy +/- chemotherapy (52.4%) and combined surgery and radiotherapy (23%). We determined the follow-up oncologist for each patient, calculated the average follow-up visits over 2.5 years for all the patients of each oncologist and compared by treatment the overall survival of the patients for the high, medium and low follow-up oncologist groups using Kaplan Meier and multiple variable regression analysis.

Results — Many oncologists saw patients 40 to 80% more often than others. There was no relationship between appointment frequency and survival for patients for any treatment group.

Conclusion — The practice of routine follow-up varies and is costly to both a health care system and to patients. Without evidence on the effectiveness of our current policies further research is required to investigate new or optimal practices.

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