Current Trends in the Follow-up of Head and Neck Cancer Patients in the UK

Abstract 

Aims

The follow-up of patients with head and neck cancer is an essential aspect of their management. Follow-up provides support and reassurance for patients and will allow early detection of recurrence and second primary tumours. However, there is little evidence of a survival benefit from follow-up. With prolonged follow-up periods, multidisciplinary teams may be under increasing pressure to see more patients and this could have a negative effect on the time and quality of consultations given to individual patients. The aim of the present study was to analyse the current trends in the follow-up of head and neck cancer patients after treatment with curative intent in the UK.

Materials and methods

A postal questionnaire was sent to all members of the British Association of Head and Neck Oncologists.

Results

Three hundred and twenty-seven questionnaires were sent and 214 were returned, making a response rate of 65.4%. One hundred and ninety-eight (61%) of these were deemed appropriate for evaluation and of these 111 (56%) clinicians followed up patients for a minimum of 5 years with 25 (13%) following patients for 10 years and 44 (22%) for life. Within the set of clinicians following patients for 5 years, 24 (12%) followed up patients with salivary gland and thyroid malignancies for a longer period of time. All clinicians concurred that the reasons for follow-up are to support patients, to detect local recurrences or metastases, second primary tumours and to monitor and manage the complications of treatment.

Conclusions

Most of the clinicians followed up their patients up to a minimum of 5 years, with a significant minority who followed up the patients treated for cancers of the head and neck for longer periods. More studies are needed to elucidate the rationale and evidence for follow-up and to determine the adequate period of surveillance.

Key words: Follow-up, head and neck cancer, imaging, recurrence, surveillance