Gynecologic Cancer Recurrence Surveillance Lacking

Detailed history, clinical examination, and patient education is most effective current method

WEDNESDAY, June 8 (HealthDay News) -- There is no evidence-based surveillance technique to detect recurrence of gynecologic cancer, but a combination of taking a detailed history, completing a physical examination, and educating patients about symptoms is the most effective current method, according to the Society of Gynecologic Oncologists recommendations published in the June issue of the American Journal of Obstetrics & Gynecology.

Ritu Salani, M.D., M.B.A., from The Ohio State University in Columbus, and colleagues reviewed the most recent data on surveillance for recurrence of gynecologic cancer in women with a complete response to primary cancer therapy.

The investigators found that taking a full history, completing a thorough physical examination, and identifying early indicators or symptoms is the most effective method for detecting recurrence in endometrial, ovarian, cervical, vaginal, and vulvar cancer survivors. There is limited evidence to suggest that cytological procedures or imaging would improve detection of recurrence at a stage that may affect response rates. Many cancer survivors transition from oncology care to primary care, typically after two years, although almost 50 percent of primary care physicians are unaware of standard guidelines for cancer surveillance for recurrence. Recommendations for improving surveillance include provision of current information, education of primary care providers and patients, promotion of healthy behaviors, and further research, specifically prospective studies, to identify evidence-based guidelines for clinical and cost-effective surveillance.

"Currently, the ideal tests and schedule for gynecologic cancer surveillance have not yet been established; however, a detailed review of symptoms and physical examination at each visit results in the detection of most recurrence," the authors write.

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