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Association between surgeon characteristics and their preferences for guideline-concordant staging and treatment for rectal cancer.

Charlton ME, Mattingly-Wells LR, Marcet JE, McMahon Waldschmidt BC, Cromwell JW. Association between surgeon characteristics and their preferences for guideline-concordant staging and treatment for rectal cancer. American journal of surgery. 2014 Nov 1; 208(5):817-23.

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Abstract:

BACKGROUND: Rectal cancer guidelines recommend transrectal ultrasound or magnetic resonance imaging for locoregional staging and neoadjuvant chemoradiation therapy (CRT) for Stage II/III disease, but studies show these are underutilized. We examined how surgeon preferences align with guidelines or vary by training. METHODS: Questionnaires on training, years of practice, and staging/treatment preferences were sent to surgeons practicing in Florida. RESULTS: Of 759 surveys distributed, 321 (42%) responded; 158 were excluded because they were trainees, not treating rectal cancer, or not board certified/eligible. Among the remaining 163, 71% were general surgeons, 18% colorectal surgeons, and 11% surgical oncologists. Colorectal surgeons and surgical oncologists were more likely than general surgeons to prefer transrectal ultrasound/magnetic resonance imaging (79% vs 50%; P < .01), and neoadjuvant CRT (71% vs 45%; P < .01). Differences remained significant after adjusting for years in practice. CONCLUSION: Increased focus on appropriate use of staging procedures and neoadjuvant CRT within general surgery training/educational programs is warranted.




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