Randomised equivalence trial: cancer follow-up
An appraisal of a study that compared telephone with traditional follow-up for survivors of breast cancer
Breast cancer is the most common cancer in women in most developed countries, and its incidence is increasing. Survival with incurable metastatic disease has improved considerably as a result of the effectiveness of screening for early disease; the impact of adjuvant treatments, such as chemotherapy, hormone therapy, and radiotherapy; and the ability to prolong life with second, third, and even fourth line systemic drugs. So the number of women who have survived or are living with breast cancer is rising.
What is appropriate follow-up for such survivors is not clear. As the authors of this study say, the English Department of Health has issued advice that, for example, follow-up in hospital should stop after three years. Organisations such as the Scottish Intercollegiate Guidelines Network, the Australian National Breast and Ovary Cancer Centre, and the American Society of Clinical Oncology have issued guidance that although similar varies in some aspects, reflecting