Fuld rapport uden bilag, 107 s. - Sundhedsstyrelsen

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patients but probably requires substantial consideration of each patient’s individual desires and opportunities. The report’s chapter on economics found a relatively high average cost of follow-up for patients with endometrial and ovarian cancer. Follow-up for patients with these two types of cancer alone in Denmark requires €1.46 million annually. This expenditure could be reduced by phasing out the follow-up from highly specialized departments and phasing in care at less specialized departments and/or specially trained nurses, practising gynaecologists and general practitioners. Further, doctors with specialized competences in these areas are presently lacking and are projected to be in short supply for many years to come. Using these specialized personnel where they generate the most benefits is therefore important. Endometrial and ovarian cancer is just two of the many types of cancer. Cancer may develop in organs or in the blood and at different stages of life. Cancer may thus differ vastly in location in the body, the stage and whether it has metastasized, treatment and survival. Cancer is thereby not one disease, and the report’s conclusions cannot uncritically be transferred to other types of cancer. Nevertheless, this report can serve as the basis for a model that can inspire similar considerations for other types of cancer. Planning future follow-up for patients with all types of cancer in Denmark it will be appropriate to perform health technology assessment on the evidence-based utility of follow-up. Based on the results of this report, it is appropriate to question whether follow-up has become a natural extension of treatment: that is, part of the course of cancer that has become a tradition and an established part of the treatment culture in Denmark. However, this does not change the viewpoint that follow-up is an intervention and that health care interventions must be evidence-based to be justified, even though follow-up is used to identify suitable patients for scientific studies. In a system with limited resources, debate on priorities is a positive sign. This report focuses objectively on follow-up for women with endometrial and ovarian cancer, and it is hoped that the report can support a scientific debate on priorities that leads to the benefits of follow-up for patients with cancer outweighing the efforts necessary to provide this care. 24 Kontrolforløb for gynækologiske kræftpatienter
projektgruppe projektdeltagere fra sundhedsstyrelsen Diana Reerman (projektleder pr. 1. marts 2009) Akademisk medarbejder, cand.scient.san.publ. Kåre Hansen (projektleder indtil 27. februar 2009) Akademisk medarbejder, cand.scient.san.publ. Maya Christel Milter (pr. 1. marts 2009) Akademisk medarbejder, cand.scient.san.publ. Birgitte Holm Petersen Bibliotekar Anna Bachmann Boje (pr. 1. marts 2009) St<strong>uden</strong>termedhjælp, bac.scient.san.publ. Mirja Elisabeth Kløjgaard (indtil 27. februar 2009) St<strong>uden</strong>termedhjælp, bac.scient.san.publ. Morten Hjulsager (projektejer) Kontorchef, cand.polit. eksterne projektdeltagere Ole Mogensen (formand) Professor, overlæge, dr.med. Gynækologisk-obstetrisk afdeling, Odense Universitetshospital Henrik Lajer Afdelingslæge, ph.d. Gynækologisk klinik, Rigshospitalet Poul Geertsen Overlæge Strålecenteret, Herlev Hospital Mansoor Raza Mirza Overlæge Onkologisk klinik, Rigshospitalet Danny Svane Overlæge, ph.d. Gynækologisk klinik, Rigshospitalet Sidse Hertz Larsen Kræftsygeplejerske Patientstøtteafdelingen, Kræftens Bekæmpelse Kontrolforløb for gynækologiske kræftpatienter 25
Page 1 and 2: Kontrolforløb for gynæKologisKe K
Page 3 and 4: indhold Hvad er MTV? 6 Sammenfatnin
Page 5 and 6: 8 Referencer 100 Bilag, denne versi
Page 7 and 8: sammenfatning introduktion Hvert å
Page 9 and 10: I bilag 2a findes de specifikke sø
Page 11 and 12: forløb, og studier fandt ingen må
Page 13 and 14: Der er generelt flere besøg og fle
Page 15 and 16: kunne retfærdiggøres også, selvo
Page 17 and 18: Follow-up usually comprises clinica
Page 19 and 20: the women with low risk. Neverthele
Page 21 and 22: cancer), blood tests (ovarian cance
Page 23: munication from the physician that
Page 27 and 28: læsevejledning Denne rapport er en
Page 29 and 30: Negativ prædiktiv værdi sandsynli
Page 31 and 32: 1 introduktion Hvert år får ca. 1
Page 33 and 34: Målgruppen for denne MTV er Kræft
Page 35 and 36: Tabel 2.1 Fakta om livmoderkræft o
Page 37 and 38: ■ I stadium IV har sygdommen bred
Page 39 and 40: ■ I stadium IV har kræften spred
Page 41 and 42: 3.1.1 Livmoderkræft Litteratursøg
Page 43 and 44: måneder efter tilbagefaldet (20).
Page 45 and 46: sive program tre tilbagefald med ul
Page 47 and 48: Symptomatiske (%) Median overlevels
Page 49 and 50: 3.3.4 Effekt af diagnostiske metode
Page 51 and 52: 3.3.4.8 MR-skanning Tabel 3.6 angiv
Page 53 and 54: 4 patient Fokus i patientkapitlet e
Page 55 and 56: 4.1.2 Fokusgruppeinterview På grun
Page 57 and 58: mindre flertal blandt kræftpatient
Page 59 and 60: 4.3 Kræftpatienters oplevelser og
Page 61 and 62: føler, at man har mulighed for at
Page 63 and 64: en kræftsygeplejerske i tilfælde
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Page 67 and 68: Samtlige 39 gynækologiske og onkol
Page 69 and 70: Angivelserne fra spørgeskemaunders
Page 71 and 72: Tabel 5.5 Undersøgelser ved mistan
Page 73 and 74: Tabel 5.7 Undersøgelser ved mistan
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5.4 Den faglige baggrund for kontro
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Tabel 5.8 Eksempler på retningslin
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Tabel 5.9 Eksempler på retningslin
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5.5.2 Udstyr Vedrørende udstyr peg
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5.8.1 Almen praksis Beskrivelsen af
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Samlet set fremgår det imidlertid,
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6 økonomi Målet med økonomikapit
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notat til journalen. Til slut aflev
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Tabel 6.2 Driftsøkonomiske omkostn
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æggestokkræft estimeret på baggr
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Tabel 6.5 Mulige variationer i de s
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7 samlet vurdering De fleste mennes
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kunne retfærdiggøres, også selvo
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15. Berchuck A, Anspach C, Evans AC
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43. Javitt MC. ACR appropriateness
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69. Pennery E, Mallet J. A prelimin
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