2. Marco teórico
4.10. PLAN DE TABULACIÓN Y ANÁLISIS
To prevent harm to patients and to decrease the burden of follow-up on health care services, the number of follow-up examinations has to be minimised. We have shown that the majority of ovarian and lung cancer patients are diagnosed at an advanced stage are candidates for minimal follow-up. Patient characteristics like age and comorbidity can further be an indication for minimal follow-up. In patients with a low relapse rate, the possible harms of routine follow-up tests can be more prominent than the benefits. Before implementing minimal follow-up in clinical practice, it is important to classify patients who have a short life expectancy or low relapse rate based on clinical evidence. In patients with a significant risk of cancer relapse, clinical studies should elucidate whether an earlier relapse treatment will improve longevity. If considered effective, the optimal follow-up schedule should be defined, taking benefits, harms and costs into account. For all cancer patients follow-up care should include the monitoring and treatment of side effects and the provision of psychosocial care, especially during the first years of follow-up. These aims become more important as patients’ outcomes improve.
ACKNOWLEDGEMENTS
The authors thank the registrars of the Netherlands Cancer Registry and the scientific staff of the Netherlands Cancer Registry for the patient registration. This study was supported by a grant from the Dutch Cancer Society, The Netherlands (Grant No. KUN 2008-4086).
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