Hulse Kate, Hurley Rhona, Lowit Anja, Maguire Roma, Paterson Claire, Douglas Catriona M
Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom.
Glasgow Head and Neck Cancer (GLAHNC) Research Group, Glasgow, United Kingdom.
Front Oncol. 2025 Jun 18;15:1632592. doi: 10.3389/fonc.2025.1632592. eCollection 2025.
Patient-initiated follow-up (PIFU) after treatment for head and neck cancer (HNC) relies on the signs and symptoms of recurrence being detectable by patients. We examine the evidence for patient-reported symptoms as an indicator of recurrence.
A search was conducted via OvidMEDLINE and Embase (2010 to January 2024) plus sources of grey literature for studies which describe patient-reported symptoms and recurrent disease. Findings are reported as per PRISMA guidelines.
Twenty studies were included which were highly heterogenous. The median sensitivity of patient-reported symptoms to detect recurrence is 47.3%. Median specificity, positive-predictive value (PPV) and negative-predictive value (NPV) were 79.3%, 9.3% and 98.0% respectively. New symptoms were generally reported at routine follow-up rather than expedited appointments.
The high specificity and NPV of patient-reported symptoms means recurrence is unlikely in the absence of symptoms. Patient education and collection of prospective data through digital health technologies may increase the effectiveness of PIFU.
头颈癌（HNC）治疗后的患者自主随访（PIFU）依赖于患者能够察觉复发的体征和症状。我们研究了患者报告症状作为复发指标的证据。
通过Ovid MEDLINE和Embase（2010年至2024年1月）以及灰色文献来源搜索描述患者报告症状和复发性疾病的研究。研究结果按照PRISMA指南报告。
纳入了20项研究，这些研究具有高度异质性。患者报告症状检测复发的中位敏感性为47.3%。中位特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为79.3%、9.3%和98.0%。新症状通常在常规随访时报告，而非加急预约时。
患者报告症状的高特异性和NPV意味着无症状时复发的可能性不大。通过数字健康技术进行患者教育和前瞻性数据收集可能会提高PIFU的有效性。
