Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors
Cervical cancer is a significant global health challenge, ranking as the fourth most common malignancy in women worldwide (age-standardized incidence: 13.3/100,000). In the UK, prevalence is markedly lower (7.6/100,000) compared to global averages, attributable to successful HPV vaccination and scre...
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MDPI AG
2025-05-01
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| Series: | Reproductive Medicine |
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| Online Access: | https://www.mdpi.com/2673-3897/6/2/12 |
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| author | Retika Mohan Mena Abdalla Anna-Lucia Koerling Sahathevan Sathiyathasan |
| author_facet | Retika Mohan Mena Abdalla Anna-Lucia Koerling Sahathevan Sathiyathasan |
| author_sort | Retika Mohan |
| collection | DOAJ |
| description | Cervical cancer is a significant global health challenge, ranking as the fourth most common malignancy in women worldwide (age-standardized incidence: 13.3/100,000). In the UK, prevalence is markedly lower (7.6/100,000) compared to global averages, attributable to successful HPV vaccination and screening programs. post-treatment follow-up is critical for monitoring recurrence, managing complications, and addressing survivors’ psychosocial needs. However, follow-up care lacks standardization, especially for advanced-stage cervical cancer. This narrative review critically assesses existing guidelines, practices, and innovative approaches to follow-up care post-cervical cancer treatment, identifying inconsistencies and offering recommendations for standardization. This review synthesizes recommendations from 12 guidelines (NCCN, ASTRO, ESGO, BSCCP, BGCS, and ESMO) to evaluate follow-up strategies for cervical cancer survivors. Emerging evidence supports risk-stratified approaches combining Patient-Initiated Follow-Up (PIFU) for low-risk patients with intensive imaging (PET/CT/MRI) for advanced stages. Psychosocial interventions, particularly for sexual health and return-to-work challenges, remain underutilized despite ESGO recommendations. Follow-up recommendations vary significantly, focusing on clinical examination and symptom-based imaging. Patient-Initiated Follow-Up (PIFU) is a growing trend, though concerns persist regarding its appropriateness for high-risk groups. Most recurrences are symptomatic, supporting less-intensive protocols for low-risk patients. Imaging methods like FDG PET/CT provide prognostic insights but are not universally adopted. Psychosocial and psychosexual care needs remain under addressed. Standardized, evidence-based follow-up protocols are essential to address disparities in survivorship care. Holistic strategies incorporating psychosocial support and tailored plans will ensure comprehensive care. This is the first review to integrate NCCN imaging standards with ESGO psychosocial care in a risk-stratified model. Future research should refine PIFU models and imaging strategies to balance resource use with quality care. Critical clinical implications emerge: (1) Risk-stratified follow-up reduces unnecessary imaging by 31% (95% CI 24–38%) in low-risk patients while maintaining 98% 5-year survival; (2) mandatory psycho-oncology referrals (per ESGO guidelines) lower depression rates by 58% (OR 0.59); (3) PET/CT should be reserved for stage IIB+ patients with symptoms, saving EUR 2300 per avoided scan. These evidence-based thresholds enable personalized survivorship care. |
| format | Article |
| id | doaj-art-de1099839dbf4651b9cd2dfe084e008f |
| institution | OA Journals |
| issn | 2673-3897 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Reproductive Medicine |
| spelling | doaj-art-de1099839dbf4651b9cd2dfe084e008f2025-08-20T02:21:47ZengMDPI AGReproductive Medicine2673-38972025-05-01621210.3390/reprodmed6020012Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer SurvivorsRetika Mohan0Mena Abdalla1Anna-Lucia Koerling2Sahathevan Sathiyathasan3King’s College Hospital NHS Foundation Trust, Orpington BR6 8ND, UKKing’s College Hospital NHS Foundation Trust, Orpington BR6 8ND, UKGuy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UKKing’s College Hospital NHS Foundation Trust, Orpington BR6 8ND, UKCervical cancer is a significant global health challenge, ranking as the fourth most common malignancy in women worldwide (age-standardized incidence: 13.3/100,000). In the UK, prevalence is markedly lower (7.6/100,000) compared to global averages, attributable to successful HPV vaccination and screening programs. post-treatment follow-up is critical for monitoring recurrence, managing complications, and addressing survivors’ psychosocial needs. However, follow-up care lacks standardization, especially for advanced-stage cervical cancer. This narrative review critically assesses existing guidelines, practices, and innovative approaches to follow-up care post-cervical cancer treatment, identifying inconsistencies and offering recommendations for standardization. This review synthesizes recommendations from 12 guidelines (NCCN, ASTRO, ESGO, BSCCP, BGCS, and ESMO) to evaluate follow-up strategies for cervical cancer survivors. Emerging evidence supports risk-stratified approaches combining Patient-Initiated Follow-Up (PIFU) for low-risk patients with intensive imaging (PET/CT/MRI) for advanced stages. Psychosocial interventions, particularly for sexual health and return-to-work challenges, remain underutilized despite ESGO recommendations. Follow-up recommendations vary significantly, focusing on clinical examination and symptom-based imaging. Patient-Initiated Follow-Up (PIFU) is a growing trend, though concerns persist regarding its appropriateness for high-risk groups. Most recurrences are symptomatic, supporting less-intensive protocols for low-risk patients. Imaging methods like FDG PET/CT provide prognostic insights but are not universally adopted. Psychosocial and psychosexual care needs remain under addressed. Standardized, evidence-based follow-up protocols are essential to address disparities in survivorship care. Holistic strategies incorporating psychosocial support and tailored plans will ensure comprehensive care. This is the first review to integrate NCCN imaging standards with ESGO psychosocial care in a risk-stratified model. Future research should refine PIFU models and imaging strategies to balance resource use with quality care. Critical clinical implications emerge: (1) Risk-stratified follow-up reduces unnecessary imaging by 31% (95% CI 24–38%) in low-risk patients while maintaining 98% 5-year survival; (2) mandatory psycho-oncology referrals (per ESGO guidelines) lower depression rates by 58% (OR 0.59); (3) PET/CT should be reserved for stage IIB+ patients with symptoms, saving EUR 2300 per avoided scan. These evidence-based thresholds enable personalized survivorship care.https://www.mdpi.com/2673-3897/6/2/12cervical cancerfollow-up carePatient-Initiated Follow-Up (PIFU)survivorshiprecurrence riskpsychosocial support |
| spellingShingle | Retika Mohan Mena Abdalla Anna-Lucia Koerling Sahathevan Sathiyathasan Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors Reproductive Medicine cervical cancer follow-up care Patient-Initiated Follow-Up (PIFU) survivorship recurrence risk psychosocial support |
| title | Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors |
| title_full | Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors |
| title_fullStr | Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors |
| title_full_unstemmed | Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors |
| title_short | Beyond the Cure: Optimizing Follow-Up Care for Cervical Cancer Survivors |
| title_sort | beyond the cure optimizing follow up care for cervical cancer survivors |
| topic | cervical cancer follow-up care Patient-Initiated Follow-Up (PIFU) survivorship recurrence risk psychosocial support |
| url | https://www.mdpi.com/2673-3897/6/2/12 |
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