Queen's University Cancer Research Institute, Division of Cancer Care and Epidemiology, Queen's University, Kingston, ON K7L 3N6, Canada.
Program in Evidence-Based Care, McMaster University, Hamilton, ON L8S 4L8, Canada.
Curr Oncol. 2022 Jan 19;29(2):439-454. doi: 10.3390/curroncol29020040.
To provide recommendations for preferred models of follow-up care for stage I-IV colorectal (CRC) cancer survivors in Ontario; to identify signs and symptoms of potential recurrence and when to investigate; and to evaluate patient information and support needs during the post-treatment survivorship period.
Consistent with the Program in Evidence-Based Medicine's standardized approach, MEDLINE, EMBASE, PubMed, Cochrane Library, and PROSPERO databases were systematically searched. The authors drafted recommendations and revised them based on the comments from internal and external reviewers.
Four guidelines, three systematic reviews, three randomized controlled trials, and three cohort studies provided evidence to develop recommendations.
Colorectal cancer follow-up care is complex and requires multidisciplinary, coordinated care delivered by the cancer specialist, primary care provider, and allied health professionals. While there is limited evidence to support a shared care model for follow-up, this approach is deemed to be best suited to meet patient needs; however, the roles and responsibilities of care providers need to be clearly defined, and patients need to know when and how to contact them. Although there is insufficient evidence to recommend any individual or combination of signs or symptoms as strong predictor(s) of recurrence, patients should be educated about these and know which care provider to contact if they develop any new or concerning symptoms. Psychosocial support and empathetic, effective, and coordinated communication are most valued by patients for their post-treatment follow-up care. Continuing professional education should emphasize the importance of communication skills and coordination of communication between the patient, family, and healthcare providers.
为安大略省 I-IV 期结直肠癌（CRC）幸存者提供首选随访护理模式的建议；确定潜在复发的迹象和症状，以及何时进行调查；并评估治疗后生存期间患者的信息和支持需求。
按照循证医学计划的标准化方法，系统地检索了 MEDLINE、EMBASE、PubMed、Cochrane 图书馆和 PROSPERO 数据库。作者起草了建议，并根据内部和外部审查员的意见进行了修订。
四项指南、三项系统评价、三项随机对照试验和三项队列研究为制定建议提供了证据。
结直肠癌的随访护理很复杂，需要由癌症专家、初级保健提供者和相关卫生专业人员进行多学科、协调的护理。尽管有有限的证据支持随访的共享护理模式，但这种方法被认为最适合满足患者的需求；然而，护理提供者的角色和责任需要明确界定，患者需要知道何时以及如何联系他们。尽管没有足够的证据推荐任何单一或组合的迹象或症状作为复发的强预测因素，但应教育患者了解这些症状，如果出现任何新的或令人担忧的症状，应知道联系哪位护理提供者。心理社会支持以及富有同情心、有效的、协调的沟通是患者在接受治疗后随访护理时最看重的。继续教育应强调沟通技巧的重要性，并协调患者、家属和医疗保健提供者之间的沟通。
