Cancer survivors' preference for follow-up care providers: a cross-sectional study from the population-based PROFILES-registry.

BACKGROUND: The best practice for the organization of follow-up care in oncology is under debate, due to growing numbers of cancer survivors. Understanding survivors' preferences for follow-up care is elementary for designing patient-centred care. Based on data from prostate cancer and melanoma survivors, this study aims to identify: 1) preferences for follow-up care providers, for instance the medical specialist, the oncology nurse or the general practitioner; 2) characteristics associated with these preferences and 3) the preferred care provider to discuss cancer-related problems. MATERIAL AND METHODS: Survivors diagnosed with prostate cancer (N = 535) and melanoma (N = 232) between 2007 and 2013 as registered in The Netherlands Cancer Registry returned a questionnaire (response rate was 71% and 69%, respectively). A latent class cluster model analysis was used to define preferences and a multinomial logistic regression analysis was used to identify survivor-related characteristics associated with these preferences. RESULTS: Of all survivors, 29% reported no preference, 40% reported a preference for the medical specialist, 20% reported a preference for both the medical specialist and the general practitioner and 11% reported a preference for both the medical specialist and the oncology nurse. Survivors who were older, lower/intermediate educated and women were more likely to have a preference for the medical specialist. Lower educated survivors were less likely to have a preference for both the medical specialist and the general practitioner. Overall, survivors prefer to discuss diet, physical fitness and fatigue with the general practitioner, and hereditary and recurrence with the medical specialist. Only a small minority favored to discuss cancer-related problems with the oncology nurse. CONCLUSION: Survivors reported different preferences for follow-up care providers based on age, education level, gender and satisfaction with the general practitioner, showing a need for tailored follow-up care in oncology. The results indicate an urgency to educate patients about transitions in follow-up care.

Transrectal ultrasonic volumetry of the prostate: in vivo comparison of different methods.

In order to assess the accuracy of various volumetric methods for screening and follow-up of prostatic disease, total prostate volume and inner zone volume were measured by transrectal ultrasonography in a screening population of 716 men. Semiplanimetric and caliper formula methods were compared with step section planimetry as the gold standard. Planimetric volumetry of the prostate is regarded as the most reproducible method for individual follow-up of total gland and inner zone volume. The prolate spheroid formula is the most reproducible of caliper formula methods for both volumes. In this study the elliptical volume was, however, more accurate than the prolate spheroid volume of the total gland, as the correlation coefficient between total elliptical volume and planimetry was higher compared to the prolate spheroid volume (0.89 vs. 0.83), and the standard deviation of the mean volumetric difference smaller. The mean total prolate spheroid volume resembled the mean total planimetric volume better than the elliptical volume did, as the mean volumetric difference was smaller. For measurement of the inner zone volume the prolate spheroid volume was more accurate that the elliptical volume. The correlation coefficient between length and planimetric volume was similar to that of width and height, which accounted for more accuracy of the elliptical volume that of the prolate spheroid volume in larger prostates. The elliptical volume might be used for incidental volumetric measurements of the total gland, and for comparison of different individuals, e.g., in preoperative evaluation or screening studies.

Errors in transrectal ultrasonic planimetry of the prostate: computer simulation of volumetric errors applied to a screening population.

Three systemic errors in routine ultrasonic planimetric volume measurements of the prostate were assessed. A computer model using ellipsoids was used to simulate the step section technique and different forms of rotational movements of the prostate during planimetry. The planimetric volume was up to 12% smaller than the exact volume, depending on the degree of rotational movement, the shape, and the length of the ellipsoid. In vivo study of a screening population showed that it is worthwhile to compare caliper length with the number of planimetric steps, as the difference might be an indication of the difference between planimetric and caliper measured volume. In shorter prostates the planimetric volume was smaller than the prolate spheroid volume when compared to longer prostates, as was seen in the computer simulation.

Parameters of prostate volume and shape in a community based population of men 55 to 74 years old.

Parameters of prostate volume and shape were determined in a community based population of 502 men 55 to 74 years old who had not undergone a previous prostate operation and did not suffer from prostatic cancer. The volumes of the total prostate and of the central relatively hypoechoic area of the prostate were determined. Of all men in this age range 95% had a total prostate volume of more than 20 cm3. Moderate correlations between age and both volume measurements were found (r = 0.26, p < 0.0001 and r = 0.34, p < 0.0001, respectively). The percentage increase per year of central hypoechoic volume (3.5%) was higher than that of total prostatic volume (2%). The average doubling time of total prostatic volume and volume of the central hypoechoic prostate was calculated to be 35 and 20 years, respectively. The roundness of the prostate as expressed by width-to-height ratio at the largest transverse section of the prostate correlated poorly with age (r = -0.13, p = 0.004). The average total prostate volumes as measured by transrectal ultrasound were 21 to 28% higher than reported average volumes measured at autopsy in men in the same age range.