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


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 healthcare system and to patients. Without evidence on the effectiveness of our current policies further research is required to investigate new or optimal practices.



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

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