Effect of general practitioner-led versus surgeon-led colon cancer survivorship care, with or without eHealth support, on quality of life (I CARE): an interim analysis of 1-year results of a randomised, controlled trial

Traditional models of survivorship care for colorectal cancer patients are managed by surgeons. These patients require comprehensive care that encompasses both monitoring and detection of recurrences, as well as rehabilitation (psychological and social support, integration into society, and secondary prevention). Survivorship care led by general practitioners (GPs) has been suggested as an alternative, as the core values of primary care include continuous and coordinated care provision. This randomised controlled trial from the Netherlands aimed to assess quality of life (QOL) in patients who received GP-led survivorship care after treatment for colon cancer compared with those who received surgeon-led care. Furthermore, they also examined the effect of an eHealth app (Oncokompas) on QOL in both patient groups. The findings suggested no meaningful difference in QOL over time between the GP-led care groups and the surgeon-led care groups, or between the patients who used the Oncokompas app and those who did not. It should be noted that QOL scores were better on nearly all subdomains in the GP-led groups than in the surgeon-led groups at baseline. This pattern may suggest some level of indication or sampling bias – perhaps patients with lower QOL and more complex disease were more likely to refuse GP-led survivorship care than those with higher QOL or less complex disease.

This paper provides an interim analysis of the results at 12 months follow-up; follow-up for this study will continue for up to 60 months after primary surgical treatment to assess long-term effects. Overall in terms of QOL, the results indicate GP-led survivorship care can be considered as an alternative to surgeon-led care within the first year after colon cancer treatment. Other outcomes, including patient and physician preferences, may be important factors for decisions about the type of survivorship care.

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