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British Gynaecological Cancer Society recommendations and guidance on patient-initiated follow-up (PIFU)
  1. Claire Newton1,2,
  2. Andy Nordin3,
  3. Philip Rolland4,
  4. Thomas Ind5,
  5. Peter Larsen-Disney6,
  6. Pierre Martin-Hirsch7,
  7. Kinter Beaver8,
  8. Helen Bolton9,
  9. Richard Peevor10,
  10. Andrea Fernandes11,
  11. Fiona Kew12,
  12. Partha Sengupta13,
  13. Tracie Miles14,
  14. Lynn Buckley15,
  15. Helen Manderville16,
  16. Ketan Gajjar17,
  17. Jo Morrison18,
  18. Jonathan Ledermann19,
  19. Jonathan Frost20,
  20. Alexandra Lawrence21,
  21. Sudha Sundar22 and
  22. Christina Fotopoulou23,24
  1. 1University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  2. 2University of Bristol, Bristol, UK
  3. 3East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
  4. 4Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
  5. 5Royal Marsden NHS Foundation Trust, London, UK
  6. 6Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  7. 7Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
  8. 8University of Central Lancashire, Preston, UK
  9. 9Addenbrooke's Hospital, London, UK
  10. 10Betsi Cadwaladr University Health Board, Bangor, Gwynedd, UK
  11. 11Royal Marsden Hospital NHS Trust, London, UK
  12. 12NHS Foundation Trust, Sheffield, UK
  13. 13University Hospital of North Durham, Newcastle, Durham, UK
  14. 14Royal United Hospital, Bath, UK
  15. 15Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
  16. 16Gateshead Health NHS Foundation Trust, Gateshead, UK
  17. 17Nottingham University Hospitals NHS Trust, Nottingham, UK
  18. 18Musgrove Park Hospital, Taunton, Somerset, UK
  19. 19UCL Cancer Institute (NCRI/MRC), London, UK
  20. 20Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
  21. 21Barts Health NHS Trust, London, UK
  22. 22University of Birmingham, Birmingham, Pennsylvania, UK
  23. 23Imperial College London, London, UK
  24. 24Queen Charlotte's and Chelsea Hospital, London, UK
  1. Correspondence to Claire Newton, Gynaecology Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol BS1 3NU, UK; claire.newton{at}


The National Cancer Survivorship Initiative through the National Health Service (NHS) improvement in the UK started the implementation of stratified pathways of patient-initiated follow-up (PIFU) across various tumor types. Now the initiative is continued through the Living With and Beyond Cancer program by NHS England. Evidence from non-randomized studies and systematic reviews does not demonstrate a survival advantage to the long-established practice of hospital-based follow-up regimens, traditionally over 5 years. Evidence shows that patient needs are inadequately met under the traditional follow-up programs and there is therefore an urgent need to adapt pathways to the needs of patients. The assumption that hospital-based follow-up is able to detect cancer recurrences early and hence improve patient prognosis has not been validated. A recent survey demonstrates that follow-up practice across the UK varies widely, with telephone follow-up clinics, nurse-led clinics and PIFU becoming increasingly common. There are currently no completed randomized controlled trials in PIFU in gynecological malignancies, although there is a drive towards implementing PIFU. PIFU aims to individualize patient care, based on risk of recurrence and holistic needs, and optimizing resources. The British Gynaecological Cancer Society wishes to provide the gynecological oncology community with guidance and a recommendations statement regarding the value, indications, and limitations of PIFU in endometrial, cervical, ovarian, and vulvar cancers in an effort to standardize practice and improve patient care.

  • patient initiated follow-up (PIFU)
  • gynaecology oncology
  • follow-up (FU)
  • gynaecological malignancies

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  • Contributors All authors have contributed equally to the authorship.

  • Funding All costs relating to the BGCS guideline meeting on patient-initiated follow-up were covered by BGCS funds.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.