The association of cognitive coping style with patient preferences in a patient-led follow-up study among colorectal cancer survivors

TL;DR

This study explores how coping styles relate to follow-up preferences in colorectal cancer survivors, finding no significant link between coping styles and follow-up choices.

Contribution

The study introduces a novel approach to understanding patient preferences in follow-up care by linking them to coping styles.

Findings

Most patients preferred intensive follow-up despite no survival benefit.

Coping styles like 'blunting' and 'monitoring' were identified, but not linked to follow-up preferences.

Low-intensity surveillance may be suitable for a wide range of patients regardless of coping style.

Abstract

Amidst the rising number of cancer survivors and personnel shortages, optimisation of follow-up strategies is imperative, especially since intensive follow-up does not lead to survival benefits. Understanding patient preferences and identifying the associated patient profiles is crucial. Coping style may be a key determinant in achieving this. Our study aims to evaluate preferences, identify coping styles and their associated factors, and explore the association between coping style and patients’ preferences in colorectal cancer (CRC) follow-up.

In a prospective multicentre implementation study, patients completed the Threatening Medical Situations Inventory (TMSI) to determine their coping style. Simultaneously patients choose their follow-up preferences for the CRC trajectory regarding frequency of tumour marker determination, location of blood sampling, and manner of contact.

A total of 188 patients completed the TMSI questionnaire after inclusion. A more intensive follow-up was preferred by 71.5% of patients. Of all patients, 52.0% had a coping style classified as ‘blunting’ and 34.0% as ‘monitoring’. Variables such as a younger age, female gender, higher educational level, and lower ASA scores were associated with having higher monitoring scores. However, there were no significant associations between follow-up preferences and patients’ coping styles.

This study suggests that none of the provided options in a patient-led follow-up are unsuitable for patients who underwent curative surgery for primary CRC, based on coping style determined at baseline. Low-intensity surveillance after curative resection of CRC may, therefore, be suitable for a wide range of patients independent of coping styles.

The online version contains supplementary material available at 10.1007/s00520-024-08758-y.