Shared follow-up care for women with low-risk endometrial cancer is a model that assists in providing holistic care, addresses the increasing demand for specialist services and facilitates equity of access to best practice care.
The summary of evidence outlines the evidence base that supports and informs Cancer Australia’s Shared follow-up and survivorship care model for women with low-risk endometrial cancer. The purpose is to provide the context, evidence base and, where applicable, the consensus base for Cancer Australia’s shared follow-up care model and resources.
The primary audience is health professionals and other stakeholders involved in the uptake and implementation of a shared model of follow-up care for women with low-risk endometrial cancer.
Shared follow-up and survivorship care for women with low-risk endometrial cancer, involving the joint participation of primary and specialist health teams, is supported by evidence from retrospective studies that endometrial cancer recurrence rates are low (1% - 3% for women considered low-risk), that most endometrial cancer recurrences are detected within the first three years after treatment, and that the majority of recurrences are symptomatic. Evidence on recurrence supports a risk-stratified approach to follow-up, with less frequent visits and less intensive surveillance tests for women at lower risk. Follow-up of endometrial cancer is generally undertaken for up to five years after treatment with more frequent visits in the first two to three years, based on the evidence of low recurrence rates.
Co-morbidities such as cardiovascular disease and their underlying risk factors should be identified and managed in follow-up, since cardiovascular disease is a greater cause of death than endometrial cancer for women treated for localised or low grade endometrial cancer. There is evidence from observational studies of supportive care and information needs, and of unmet needs, for women with endometrial cancer, that should be addressed in follow-up care. Shared follow-up care can help improve access to person-centred holistic care, improve management of co-morbidities and supportive care needs, and strengthen care coordination.