Medscape: Is collecting long-term cancer follow-up data worth it?

UC expert says patient mobility among health care systems makes follow up a challenge

Medscape recently published on story on the topic of whether or not it's worth the effort to follow cancer patients over many years to catch tumors that recur, improve outcomes, even reveal important trends. Those long-term cancer follow-ups require extensive human resources and will inevitably decrease over time.

One of the experts interviewed for the story was Tammy Holm, MD, PhD, assistant professor in the Department of Surgery at the UC College of Medicine. The article focuses on a recent analysis of lifetime follow-up data in the National Cancer Database (NCDB). The study, published October 24 in Annals of Surgical Oncology, evaluated the completeness of data collected between 1989 and 2014 and estimated the hours required to compile it.

Medscape wrote that when she and her colleagues are talking about the NCDB, it's usually "about how we would alter it to get more information."

Tammy Holm, MD, PhD, assistant professor in the Department of Surgery at the UC College of Medicine

Tammy Holm, MD, PhD, assistant professor in the Department of Surgery at the UC College of Medicine/Photo/Colleen Kelley/UC Creative + Brand

"What makes this paper interesting is clinical researchers are always complaining about the data that's missing," said Holm. "[The study authors] turned it on its head by saying maybe we are collecting too much of the wrong thing."

Holm was not associated with the current study.

Keeping up with patients is inherently challenging in the United States, Medscape reported. For starters, patients are mobile, especially when it comes to healthcare providers. For instance, many patients don't receive follow-up care at the hospitals where they have surgery and may change physicians because of a physical move or, more often, shifts in the insurance landscape. In addition, providers in a patient's network can change from year to year.

"In Cincinnati, there are so many different hospital systems and patients bounce between the systems so frequently and have very scattered care," said Holm. Following up becomes difficult simply from a logistical and practical standpoint.

Despite the drawbacks to the NCDB approach to patient follow-up, collecting long-term cancer outcomes data can further understanding of cancer trends and outcomes.

"I think it's time to refine the tool," Holm said. "But we have to be careful not to throw the baby out with the bathwater." There's nuance to consider, she noted. For instance, the survival rates of different cancers mandate different lengths and types of follow-up.

Read the entire story here. Subscription may be required to access the article. 

Lead image of metastic melanoma cells/National Cancer Institute

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