Follow-up of colon cancer patients; causes of distress and need for supportive care: Results from the ICARE Cohort Study T. Wieldraaijer a, * , L.A.M. Duineveld a , K.M. van Asselt a , A.A.W. van Geloven b , W.A. Bemelman c , H.C.P.M. van Weert a , J. Wind a , on behalf of ICARE study group a Department of Primary Care, Academic Medical Centre, Amsterdam, The Netherlands b Department of Surgery, Tergooi Hospitals, Hilversum/Blaricum, The Netherlands c Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands Accepted 18 August 2016 Available online --- Abstract Background: Colon cancer survivors experience physical and psychosocial problems that are currently not adequately addressed. This study investigated distress in patients after curative surgery for colon cancer and studied how this corresponds with the need for supportive care. Methods: Prospective cohort of patients with stage IeIII colon carcinoma, treated with curative intent, currently in follow-up at 6 different hospitals. A survey recorded symptoms, experienced problems, and (un)expressed needs. Satisfaction with supportive care was recorded. Results: Two hundred eighty four patients were included; 155 males and 129 females, with a mean age of 68 years (range 33e95), and a median follow-up of 7 months. 227 patients completed the survey. Patients experienced a median of 23 symptoms in the week before the survey, consisting of a median of 10 physical, 8 psychological and 4 social symptoms. About a third of these symptoms was felt to be a problem. Patients with physical problems seek supportive care in one in three cases, while patients with psychosocial problems only seek help in one in eight cases. Patients who recently finished treatment, finished adjuvant chemotherapy, or had a stoma, had more symptoms and needed more help in all domains. Patients most frequently consulted general practitioners (GPs) and surgeons, and were satisfied with the help they received. Conclusion: Colon cancer survivors experience many symptoms, but significantly fewer patients seek help for a psychosocial problem than for a physical problem. Consultations with supportive care are mainly with GPs or surgeons, and both healthcare providers are assessed as providing satisfying care. Ó 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. Keywords: Colon cancer; Follow-up; Patients; Symptoms; Needs; Supportive care Introduction Colorectal cancer (CRC) is one of the most common types of cancer, with more than 15,000 new patients in the Netherlands in 2015. 1,2 Increasing incidence, improved treatment, and a recent national screening programme involving faecal occult blood tests and colonoscopy to detect CRC at the earliest possible stage will lead to a considerable rise in the number of patients that are treated with curative intent. 1e5 After curative treatment for colon cancer, patients are monitored for five years in a follow- up programme that includes periodic laboratory and imag- ing examinations, and regular consultations. 2 The national guideline does not recommend which healthcare provider should coordinate follow-up, which accounts for different * Corresponding author. Department of Primary Care, AMC-UvA, Post- box 22660, 1100 DD, Amsterdam, The Netherlands. E-mail address: t.wieldraaijer@amc.uva.nl (T. Wieldraaijer). http://dx.doi.org/10.1016/j.ejso.2016.08.011 0748-7983/Ó 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. Available online at www.sciencedirect.com ScienceDirect EJSO xx (2016) 1e8 www.ejso.com Please cite this article in press as: T.Wieldraaijer a,) t.wieldraaijer@amc.uva.nlL.A.M.Duineveld a K.M.van Asselt a A.A.W.van Geloven b W.A.Bemelman c H.C.P.M.van Weert a J.Wind a on behalf ofICARE study group