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Large variation between hospitals in follow-up for colorectal cancer in southern Netherlands

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aims of the study were to describe the follow-up of colorectal cancer (CRC) patients in southern Netherlands and examine their overall and disease-free survival.

Methods

Patients newly diagnosed with CRC in 2003–2005 and 2008 with a survival of at least 1 year after diagnosis and recorded in the retrospective Eindhoven Cancer Registry were included (n = 579). Follow-up was defined as at least one liver imaging and at least two carcinoembryonic antigen (CEA) measurements. Logistic regression analyses were conducted to assess determinants of follow-up. Proportions of patients undergoing colonoscopy, CEA measurements and liver and chest imaging were calculated. Overall and disease-free survival were calculated.

Results

Patients ≥75 years (odds ratio (OR) 0.5 (95% confidence interval (CI) 0.3–0.7)) were less likely to receive follow-up, contrasting patients <50 years (OR 3.1 (95% CI 1.3–7.4)). In 2008, follow-up intensity increased (OR 2.3 (95% CI 1.2–4.3)), especially for liver imaging and CEA measurements. There were large differences in follow-up intensity and activities between hospitals, which were unaffected by comorbidity: ranges for colonoscopy 15–73 %, CEA measurement 46–91 % and imaging of the liver 22–70 % between hospitals. No effect of follow-up intensity was found on 5-year disease-free survival for patients aged <75 years (64 vs. 68 %; p = 0.6). Similarly, no effect of follow-up intensity on 5-year overall survival was found in these patients (77 vs. 82 %; p = 0.07).

Conclusion

Large variation in follow-up was found for patients with CRC, mainly declining with age and hospital of follow-up. Over time, follow-up became more intensive, especially with respect to liver imaging and CEA measurements. However, follow-up consisting of at least one liver imaging and at least two CEA measurements did not improve overall and disease-free survival.

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Acknowledgments

The authors thank the registration team of the Eindhoven Cancer Registry for their dedicated data collection. We would like to thank the following hospitals for their cooperation: Amphia Hospital, Jeroen Bosch Hospital, Catharina Hospital Eindhoven, TweeSteden Hospital, VieCuri Medical Centre, Maxima Medical Centre Eindhoven and Veldhoven, Elkerliek Hospital and St Elisabeth Hospital. This study was carried out with a grant from the Dutch Cancer Society (IKZ 2006–3588).

Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. Eindhoven Cancer Registry, Comprehensive Cancer Centre South, PO Box 231, 5600 AE, Eindhoven, the Netherlands

    L. N. van Steenbergen, J. W. W. Coebergh & V. E. P. P. Lemmens

  2. Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, the Netherlands

    I. H. J. T. de Hingh, H. J. T. Rutten & R. G. Orsini

  3. Department of Surgery, Maastricht University Medical Center, PO Box 616, 6200, MD, Maastricht, the Netherlands

    H. J. T. Rutten

  4. Department of Gastroenterology, Amphia Hospital, PO Box 90157, 4800 RL, Breda, the Netherlands

    M. C. M. Rijk

  5. Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, the Netherlands

    J. W. W. Coebergh & V. E. P. P. Lemmens

Authors
  1. L. N. van Steenbergen
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  2. I. H. J. T. de Hingh
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  3. H. J. T. Rutten
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  4. M. C. M. Rijk
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  5. R. G. Orsini
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  6. J. W. W. Coebergh
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  7. V. E. P. P. Lemmens
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Corresponding author

Correspondence to L. N. van Steenbergen.

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van Steenbergen, L.N., de Hingh, I.H.J.T., Rutten, H.J.T. et al. Large variation between hospitals in follow-up for colorectal cancer in southern Netherlands. Int J Colorectal Dis 28, 1257–1265 (2013). https://doi.org/10.1007/s00384-013-1693-x

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  • DOI: https://doi.org/10.1007/s00384-013-1693-x

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