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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
Open AccessArticle

Follow-Up for Women after Treatment for Cervical Cancer

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Juravinski Regional Cancer Centre, Hamilton, ON, Canada
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Department of Radiation Oncology, University Health Network, Princess Margaret Hospital, Toronto, ON, Canada
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Cancer Care Ontario Program in Evidence-based Care, McMaster University, Hamilton, ON, Canada
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Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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Division of Gynecologic Oncology, The Ottawa Hospital Regional Cancer Centre, Ottawa, ON, Canada
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Please see the page for the Gynecology Cancer Disease Site Group (www.cancercare.on.ca/cms/ one.aspx?pageId=10245 at March 2010) in the Program in Evidence-Based Care section of the Cancer Care Ontario Web site for a complete list of current group members.
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2010, 17(3), 65-69; https://doi.org/10.3747/co.v17i3.514
Received: 1 May 2010 / Revised: 8 May 2010 / Accepted: 8 May 2010 / Published: 1 June 2010
Question: What is the most appropriate follow-up strategy for patients with cervical cancer who are clinically disease-free after receiving primary treatment? Perspectives: For women with cervical cancer who have been treated with curative intent, follow-up includes identification of complications related to treatment and intervention in the event of recurrent disease. Most women who recur with cervical cancer are not curable; however, early identification of recurrence can alter disease management or treatment-planning options, and for those with a central pelvic recurrence and no evidence of distant disease, there is a potential for cure with additional therapy. Follow-up protocols in this population are variable, using a number of tests at a variety of intervals with questionable outcomes. Cancer Care Ontario’s Program in Evidence-Based Care is sponsored by Cancer Care Ontario and the Ministry of Health and Long-Term Care. Outcomes: Outcomes of interest included recurrence, survival, and quality of life. Methodology: The Gynecology Cancer Disease Site Group (DSG) conducted a systematic review of the literature and a narrative review of emerging clinical issues to inform the most appropriate follow-up strategy for patients with cervical cancer. The evidence was insufficient to specify a clinically useful recommended follow-up schedule, and therefore, the expert consensus opinion of the Gynecology Cancer DSG was used to develop recommendations on patient surveillance. The resulting recommendations were reviewed and approved by the Gynecology Cancer dsg and by the Program in Evidence-Based Care Report Approval Panel. An external review by Ontario practitioners completed the final phase of the review process. Feedback from all parties was incorporated to create the final practice guideline. Results: The systematic review of the literature identified seventeen retrospective studies. The Gynecology Cancer dsg used a consensus process to develop recommendations based on the available evidence from the systematic review, the narrative review, and the collective clinical experience and judgment of the DSG members. Practice Guideline: The recommendations in this practice guideline are based on the expert consensus opinion of the Gynecology Cancer dsg, informed by evidence from retrospective studies. These are some general features of an appropriate follow-up strategy: 1. At a minimum, follow-up visits with a complete physical examination, including a pelvic–rectal exam and a patient history, should be conducted by a physician experienced in the surveillance of cancer patients. 2. There is little evidence to suggest that vaginal vault cytology adds significantly to the clinical exam in detecting early disease recurrence. 3. Routine use of various other radiologic or biologic follow-up investigations in asymptomatic patients is not advocated, because the role of those investigations has yet to be evaluated in a definitive manner. 4. A reasonable follow-up schedule involves follow-up visits every 3–4 months in the first 2 years and every 6–12 months in years 3–5. Patients should return to annual population-based general physical and pelvic examinations after 5 years of recurrence-free follow-up.
Keywords: cervical cancer; follow-up; schedule; recurrence; practice guideline; surveillance cervical cancer; follow-up; schedule; recurrence; practice guideline; surveillance
MDPI and ACS Style

Elit, L.; Fyles, A.W.; Oliver, T.K.; Devries–Aboud, M.C.; Fung-Kee-Fung, M.; m.o.t.G.C.D.S.G.o.C.C.O.P.i.E.-B.C. Follow-Up for Women after Treatment for Cervical Cancer. Curr. Oncol. 2010, 17, 65-69. https://doi.org/10.3747/co.v17i3.514

AMA Style

Elit L, Fyles AW, Oliver TK, Devries–Aboud MC, Fung-Kee-Fung M, motGCDSGoCCOPiE-BC. Follow-Up for Women after Treatment for Cervical Cancer. Current Oncology. 2010; 17(3):65-69. https://doi.org/10.3747/co.v17i3.514

Chicago/Turabian Style

Elit, L.; Fyles, A.W.; Oliver, T.K.; Devries–Aboud, M.C.; Fung-Kee-Fung, M.; members of the Gynecology Cancer Disease Site Group of Cancer Care Ontario’s Program in Evidence-Based Care. 2010. "Follow-Up for Women after Treatment for Cervical Cancer" Curr. Oncol. 17, no. 3: 65-69. https://doi.org/10.3747/co.v17i3.514

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