Patient initiated follow-up in head and neck cancer

After completion of curative intent treatment, clinical follow-up currently forms an essential cornerstone of the ongoing management for head and neck cancer (HNC) patients. The purpose of followup is multifaceted but includes the assessment of ongoing treatment morbidity and functional deficit, the early detection of recurrent disease or second primary tumours, and the education of patients and caregivers, including support with risk factor modification. Current UK HNC guidelines align closely with those from other international societies in recommending that patients undergo clinical follow-up every two months for the first two years after treatment, and then every threeto- six months for the next three years. This schedule is predicated on the fact that the risk of recurrence reduces over time, being highest in the first two years after completing treatment. Yet, despite the accepted importance of follow-up, the current system has significant limitations.