Gyn. oncologists relying more on PCPs: changing physician roles in cervical cancer surveillance.(Gynecology)

BIG SKY, MONT. -- In a reversal of long-standing practice, gynecologic oncologists are increasingly sending cervical cancer patients back to their primary care physician or gynecologist for posttreatment surveillance, Dr. Ira R. Horowitz observed at a meeting on ob.gyn., gynecologic oncology, and reproductive endocrinology.

"I think you all are going to be seeing a lot more of these patients. I'm seeing more and more.... I'd like to say that it's because gyn. oncologists, being good people, like sending back your patients. The truth of the matter is they're costing the gyn. oncologists money," said Dr. Horowitz, the Willaford Ransom Leach Professor and director of gynecologic oncology at Emory University in Atlanta.

Most recurrences of invasive cervical cancer happen within 2-3 years. The recommended posttreatment surveillance schedule consists of follow-up office visits every 3 months for the first 2 years, every 6 months for another 2 years, and then annually.

At each cancer surveillance visit the patient should have a Pap smear and a thorough physical examination, including bimanual pelvic exam and lymph node assessment. The patient also should be asked whether she has experienced abnormal vaginal bleeding, changes in bowel or ...