Examining Adherence With Recommendations for Follow-Up in the Prevention Among Colorectal Cancer Survivors Study

Nikki A. Hawkins

Zahava Berkowitz

Juan Rodriguez

Jacqueline W. Miller

Susan A. Sabatino

Lori A. Pollack

cancer survivorship, adherence, cancer surveillance, colorectal cancer, long-term care, public health
ONF 2015, 42(3), . DOI: 10.1188/15.ONF.233-240

Purpose/Objectives: To explore the impact of health professionals’ recommendations for medical follow-up among colorectal cancer (CRC) survivors.

Design: Cross-sectional survey.

Setting: Mailed surveys and telephone interviews with CRC survivors in California.

Sample: 593 adults diagnosed with a primary CRC six to seven years before the time of the study.

Methods: Participants were identified through California Cancer Registry records and invited to take part in a survey delivered via mail or through telephone interview.

Main Research Variables: The survey assessed cancer history, current preventive health practices, health status, demographics, and other cancer-related experiences.

Findings: More than 70% of CRC survivors received recommendations for routine checkups, surveillance colonoscopy, or other cancer screenings after completing CRC treatment, and 18%–22% received no such recommendations. Recommendations were sometimes given in writing. Receiving a recommendation for a specific type of follow-up was associated with greater adherence to corresponding guidelines for routine checkups, colonoscopy, mammography, and Papanicolaou testing. Receiving written (versus unwritten) recommendations led to greater adherence only for colonoscopy.

Conclusions: Most CRC survivors reported receiving recommendations for long-term medical follow-up and largely adhered to guidelines for follow-up. Receiving a health professional’s recommendation for follow-up was consistently associated with patient adherence, and limited evidence showed that recommendations in written form led to greater adherence than unwritten recommendations.

Implications for Nursing: Given the increasingly important role of the oncology nurse in survivorship care, nurses can be instrumental in ensuring appropriate surveillance and follow-up care among CRC survivors. Conveying recommendations in written form, as is done in survivorship care plans, may be particularly effective.

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