High efficacy and patient satisfaction with a nurse-led colorectal cancer surveillance programme with 10-year follow-up.

BACKGROUND

Surveillance after colorectal cancer resection remains contentious, and faces several contemporary issues. Patient-centred care, intensive surveillance programmes and patient complexity increase the burden of surveillance on consultant-led clinics. Recent years have seen reshaping of nursing roles to meet healthcare demand. Nurse-led follow-up after colorectal cancer has been piloted, but not validated. We report outcomes from a nurse-led colorectal cancer surveillance clinic functioning in our institution since 2008, the longest term follow-up in the published literature.

METHODS

Included patients were surveilled through the clinic from 2008 to 2018 by credentialled nurses who performed history, examination and investigations as per the local protocol. Demographic, tumour-related, outcome-related and patient satisfaction data were extracted from a prospectively maintained database. Primary outcomes were compliance with surveillance protocol and patient satisfaction.

RESULTS

A total of 138 patients were included in the analysis. Mean time in surveillance was 25.4 months. Surveillance investigation protocol compliance was 97.4% overall. Five recurrences (3.6%) were detected during surveillance. In patients who developed recurrence, protocol compliance was 100%, and no clinical features of recurrence were newly found when patients were reviewed by a consultant surgeon. All recurrences during surveillance were detected by nursing staff. Response rate to the patient satisfaction survey was 90%. 96.3% of patients reported receiving adequate explanation regarding cancer surveillance and nurse-led care. 90.7% of patients rated the clinic as 'excellent' and 9.3% as 'good'.

CONCLUSION

Our results show a high level of efficacy and patient satisfaction associated with a nurse-led colorectal cancer surveillance clinic over a prolonged time period, the longest in the published literature.