Determining cancer survivors' preferences to inform new models of follow-up care.

Specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors' needs. Alternative models informed by survivors' preferences are urgently needed. It is unknown if follow-up preferences differ by cancer type. We conducted the first study to assess British cancer survivors' follow-up preferences, and the first anywhere to compare the preferences of survivors from different cancers.

A discrete choice experiment questionnaire was mailed to 1201 adults in Northeast Scotland surviving melanoma, breast, prostate or colorectal cancer. Preferences and trade-offs for attributes of cancer follow-up were explored, overall and by cancer site.

668 (56.6%) recipients (132 melanoma, 213 breast, 158 prostate, 165 colorectal) responded. Cancer survivors had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up. However, cancer survivors appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling. Longer appointments were also valued. Telephone and web-based follow-up and group counselling, were not considered desirable. Survivors of colorectal cancer and melanoma would see any alternative provider for greater continuity, whereas breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a general practitioner.

Cancer survivors may accept non-consultant follow-up if compensated with changes elsewhere. Care continuity was sufficient compensation for most cancers. Given practicalities, costs and the potential to develop continuous care, specialist nurse-led cancer follow-up may be attractive.British Journal of Cancer advance online publication, 1 November 2016; doi:10.1038/bjc.2016.352 www.bjcancer.com.

British journal of cancer. 2016 Nov 01 [Epub ahead of print]

Peter Murchie, Patricia F Norwood, Marta Pietrucin-Materek, Terry Porteous, Philip C Hannaford, Mandy Ryan

Centre for Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK., Health Economics Research Unit (HERU), Division of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK., Health Services Research Unit (HSRU), Division of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.

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