The process and outcomes of a nurse-led colorectal cancer follow-up clinic
Article first published online: 30 MAR 2012
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 14, Issue 5, pages e245–e249, May 2012
How to Cite
McFarlane, K., Dixon, L., Wakeman, C. J., Robertson, G. M., Eglinton, T. W. and Frizelle, F. A. (2012), The process and outcomes of a nurse-led colorectal cancer follow-up clinic. Colorectal Disease, 14: e245–e249. doi: 10.1111/j.1463-1318.2011.02923.x
- Issue published online: 30 MAR 2012
- Article first published online: 30 MAR 2012
- Accepted manuscript online: 19 DEC 2011 09:38AM EST
- Received 20 July 2011; accepted 21 October 2011; Accepted Article online 19 December 2011
- Colorectal cancer;
- nurse-led follow-up;
Aim Evidence suggests that follow-up after colorectal cancer improves survival. Colorectal cancer is so common that patient follow-up can overwhelm a service, affecting the ability to see new referrals and reassess patients seen previously who have new symptoms. In order to cope with this demand a nurse-led follow-up service was started in 2004. We aimed to review the results of a nurse-led colorectal cancer follow-up clinic.
Method Between 1 December 2004 and 31 January 2011, patients who underwent resection for colorectal cancer were followed up by a nurse specialist according to a protocol determined by the colorectal surgeons in the unit. All patient details were recorded prospectively in a purpose designed database.
Results Nine hundred and fifty patients were followed up over 7 years. Some 368 patients were discharged from the follow-up programme, 474 patients remain actively involved in the programme and 108 patients died. Of the patients discharged from the follow-up scheme 269 (73%) were discharged to their general practitioner free of disease after 5 years. Of the 108 who patients died, 98 were as a result of colorectal cancer. Twenty patients (2.1%) were identified with local (peri-anastomotic) disease recurrence and 93 patients (9.8%) were found to have developed distant metastatic disease. Of these, 65 patients (6.8%) were referred for palliative care and 28 (2.9%) had surgery for focal metastatic disease of whom 18 were still alive at the time of this analysis.
Conclusion This paper shows that a nurse-led clinic for colorectal cancer follow-up can achieve satisfactory results with detection rates of recurrent or metastatic disease comparable to consultant follow-up. A nurse-led clinic provides the benefits of follow-up without overwhelming the consultant colorectal surgical clinic practice.