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The COVID-19 pandemic: An opportunity to rethink and harmonise the frequency of follow-up visits for patients with early stage breast cancer.
Surujballi, Julian; Shah, Hely; Hutton, Brian; Alzahrani, Mashari; Beltran-Bless, Ana-Alicia; Shorr, Risa; Larocque, Gail; McGee, Sharon; Cole, Katherine; Ibrahim, Mohammed F K; Fernandes, Ricardo; Arnaout, Angel; Stober, Carol; Liu, Michelle; Sienkiewicz, Marta; Saunders, Deanna; Vandermeer, Lisa; Clemons, Mark.
  • Surujballi J; Division of Medical Oncology (Department of Medicine), The Ottawa Hospital Cancer Centre, Ottawa, Canada.
  • Shah H; Department of Medicine, The Ottawa Hospital, Ottawa, Canada.
  • Hutton B; The University of Ottawa School of Epidemiology and Public Health, and Ottawa Hospital Research Institute, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Alzahrani M; Division of Medical Oncology (Department of Medicine), The Ottawa Hospital Cancer Centre, Ottawa, Canada.
  • Beltran-Bless AA; Division of Medical Oncology (Department of Medicine), The Ottawa Hospital Cancer Centre, Ottawa, Canada.
  • Shorr R; The Ottawa Hospital, Ottawa, Canada.
  • Larocque G; The Ottawa Hospital, Ottawa, Canada.
  • McGee S; Division of Medical Oncology (Department of Medicine), The Ottawa Hospital Cancer Centre, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Cole K; Division of Medical Oncology (Department of Medicine), The Ottawa Hospital Cancer Centre, Ottawa, Canada.
  • Ibrahim MFK; Thunder Bay Regional Health Sciences Centre-Cancer Care, Thunder Bay, Canada.
  • Fernandes R; London Health Sciences Centre, Ottawa, Canada.
  • Arnaout A; Department of Surgery, The Ottawa Hospital, Ottawa, Canada.
  • Stober C; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Liu M; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Sienkiewicz M; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Saunders D; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Vandermeer L; Ottawa Hospital Research Institute, Ottawa, Canada.
  • Clemons M; Division of Medical Oncology (Department of Medicine), The Ottawa Hospital Cancer Centre, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: mclemons@toh.ca.
Cancer Treat Rev ; 97: 102188, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1163603
ABSTRACT

PURPOSE:

While routine, in-person follow-up of early-stage breast cancer patients (EBC) after completion of initial treatment is common, the COVID-19 pandemic has resulted in unprecedented changes in clinical practice. A systematic review was performed to evaluate the evidence supporting different frequencies of routine follow-up.

METHODS:

MEDLINE and the Cochrane Collaboration Library were searched from database inception to July 16, 2020 for randomized controlled trials (RCTs) and prospective cohort studies (PCS) evaluating different frequencies of routine follow-up. Citations were assessed by pairs of independent reviewers. Risk of Bias (RoB) was assessed using the Cochrane RoB tool for RCTs and the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies. Findings were summarized narratively.

RESULTS:

The literature search identified 3316 studies, of which 7 (6 RCTs and 1 PCS) were eligible. Study endpoints included; quality of life (QoL; 5 RCTs and 1 PCS), disease free survival (DFS) (1 RCT), overall survival (OS) (1 RCT) and cost-effectiveness (1 RCT). The results showed reduction in follow-up frequency had no adverse effect on QoL (6 studies, n = 920), DFS (1 trial, n = 472) or OS (1 trial, n = 472), but improved cost-effectiveness (1 trial, n = 472). Four RCTs specifically examined follow-up on-demand versus scheduled follow-up visits and found no statistically significant differences in QoL (n = 544).

CONCLUSION:

While no evidence-based guidelines suggest that follow-up of EBC patients improves DFS or OS, routinely scheduled in-person assessment is common. RCT data suggests that reduced frequency of follow-up has no adverse effects.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / Breast Neoplasms / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Female / Humans Language: English Journal: Cancer Treat Rev Year: 2021 Document Type: Article Affiliation country: J.ctrv.2021.102188

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / Breast Neoplasms / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Female / Humans Language: English Journal: Cancer Treat Rev Year: 2021 Document Type: Article Affiliation country: J.ctrv.2021.102188