Evaluation of the Psychological eifects of an Intensive follow-up program ‘from a distance’ as compared to care as usual in colorectal cancer patients

Objectives. This pilot study examines the attitude, satisfaction, effects and preferences related to a new type of intensive follow-up among colorectal cancer patients after curative treatment. The aim of the study was to examine whether an intensive follow-up program with serum Carcino Embryonic Antigen (CEA) measurements, but with less scheduled outpatient clinic visits, is feasible in terms of patients’ evaluation and perception. Design and Method. This study had a between-subjects design with a total of 109 patients completed a questionnaire. The questionnaire contained questions about patients’ attitude towards the follow-up program, about the existence of depression, anxiety and cancer worries and about the satisfaction with the follow-up program. Beyond that we evaluated patients’ preferences for an eventual further follow-up program. The trial group of patients underwent a monthly serum CEA blood test and a visited the the physician once every 6 months to a year. The comparison group brought a visit each 3 to 6 months to the physician in addition to an ultrasound once per half year. Results. No significant differences were found between the trial group and the comparison group according to the attitude towards follow-up, anxiety, depression and cancer worries. The trial group was even more satisfied with their follow-up program (p = 0.02). Most patients in both groups preferred their current follow-up program, though the majority of the trial patients had a second preferred option for the monthly blood tests without contact with the physician. Patients in the comparison group who suffered from more anxiety, depression and cancer worries preferred a more intensive follow-up program including the monthly serum CEA blood test. Conclusion. The positive evaluation of the intensive follow-up program and the preference of the trial group for the monthly serum CEA blood test rather than visiting the physician makes intensive follow-up without increase in outpatient clinic visits feasible