The future of continuing care interventions for colorectal cancer survivors: clinicians’ opinions and current practices

Abstract

Purpose: Despite improving survival rates following colorectal cancer (CRC), post-treatment side-effects such as bowel and sexual dysfunction continue to impair survivors’ quality of life. These effects can persist, even years after completing primary treatment. This study aimed to explore current assessment and management practices of clinical stakeholders, types of available interventions, and their perceived effectiveness. Methods: An online survey was developed in consultation with CRC survivors and clinicians including colorectal surgeons and cancer nurses. Clinicians with experience of treating patients with CRC following primary treatment were invited to participate. The survey was launched online, and responses were descriptively analyzed using SPSS® Statistics for Windows®. Results: Of 101 respondents, 87.2% had >5 years’ experience working with CRC survivors. There was heterogeneity of methods used to assess ongoing issues in survivors. The referral pathways for a given treatment side-effect were also variable. Main barriers to delivering ongoing care were increased wait times to see a new healthcare provider and limited financial and geographical access to healthcare services. Respondents (87.2%) identified that establishing clinical pathways would better facilitate ongoing care for CRC survivors and 61.3% recognized the potential for new interventions for certain treatment effects. Conclusion: There is significant variability in assessment and management of long-term post-treatment effects following treatment for CRC. A streamlined process including practical advice and referral pathways for the management of CRC survivors’ ongoing care is required to better equip clinicians to effectively manage post-treatment effects that significantly impact the quality of life of survivors.