Abstract
Objectives
Current guidelines advise post-treatment surveillance of Head and Neck Cancer (HNC) patients should involve scheduled appointments with a variety of practitioners. Increasing numbers of HNC survivors raises the burden to provide efficient and effective care. With resource limitation there is growing importance to identify how surveillance can be justified and optimised for survivors. This systematic review presents current evidence on patient-perspectives of post-treatment HNC surveillance, aiming to inform future work putting patient priorities at the forefront of surveillance planning.
Design
MEDLINE, Embase, the Cochrane Library, NIHR Dissemination Centre, The Kings Fund Library, Clinical Evidence, NHS Evidence and NICE Clinical Evidence were searched to identify publications regarding patient-perspectives of HNC post-treatment surveillance. Studies not reporting on both surveillance and patient-perspectives were excluded.
Results
3558 citations were screened and 49 full-text articles reviewed. 16 studies were included in the final review. 3 authors reviewed all articles prior to final analysis to ensure all met inclusion criteria. Most evidence was low-quality. Study models returned included cross-sectional surveys, structured-interviews and one systematic review. Overall, positive perceptions of HNC surveillance mostly related to increased reassurance. Negative perceptions predominantly focused on anxiety and fear of recurrence, but a lack of psychological support and inadequate access to certain aspects of care were also reported.
Conclusions
This systematic review demonstrates that patients' perceptions of surveillance after HNC are mostly positive, feeling it provides reassurance. However, several studies report unmet needs, particularly regarding managing anxiety.
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