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

Mary E Charlton; Lorren R Mattingly-Wells; Jorge E Marcet; Brenna C McMahon Waldschmidt; John W Cromwell

doi:10.1016/j.amjsurg.2014.03.010

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

Journal article

Peer reviewed

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

Mary E Charlton, Lorren R Mattingly-Wells, Jorge E Marcet, Brenna C McMahon Waldschmidt and John W Cromwell

The American journal of surgery, Vol.208(5), pp.817-823

11/2014

DOI: 10.1016/j.amjsurg.2014.03.010

PMCID: PMC4267050

PMID: 24997492

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https://www.ncbi.nlm.nih.gov/pmc/articles/4267050View

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Abstract

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. Questionnaires on training, years of practice, and staging/treatment preferences were sent to surgeons practicing in Florida. 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. Increased focus on appropriate use of staging procedures and neoadjuvant CRT within general surgery training/educational programs is warranted.

Rectal cancer

Neoadjuvant therapy

Guideline adherence

Details

Title: Subtitle: Association between surgeon characteristics and their preferences for guideline-concordant staging and treatment for rectal cancer
Creators: Mary E Charlton - Department of Epidemiology, University of Iowa College of Public Health, 145 N Riverside Drive, Iowa City, IA 52242, USA
Lorren R Mattingly-Wells - Department of Nursing, VA Medical Center, Memphis, TN, USA
Jorge E Marcet - Division of Colon and Rectal Surgery, Department of Surgery, University of South Florida, Tampa, FL, USA
Brenna C McMahon Waldschmidt - Department of Epidemiology, University of Iowa College of Public Health, 145 N Riverside Drive, Iowa City, IA 52242, USA
John W Cromwell - Division of Gastrointestinal Surgery, Minimally Invasive and Bariatric Surgery, Department of Surgery, University of Iowa College of Medicine, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.208(5), pp.817-823
DOI: 10.1016/j.amjsurg.2014.03.010
PMID: 24997492
PMCID: PMC4267050
NLM abbreviation: Am J Surg
ISSN: 0002-9610
eISSN: 1879-1883
Publisher: Elsevier Inc
Language: English
Date published: 11/2014
Academic Unit: Health Management and Policy; Epidemiology; Surgery
Record Identifier: 9983995061702771

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