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Patterns and characteristics of patients’ selection of cancer surgeons
Journal article   Peer reviewed

Patterns and characteristics of patients’ selection of cancer surgeons

Natalie J Del Vecchio, Natoshia M Askelson, Knute D Carter, Elizabeth Chrischilles, Charles F Lynch and Mary E Charlton
The American journal of surgery, Vol.221(5), pp.1033-1041
05/2021
DOI: 10.1016/j.amjsurg.2020.09.041
PMCID: PMC8110945
PMID: 33969822

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Abstract

Despite evidence of volume-outcome relationships for cancer surgery, treatment at low-volume hospitals remains common. Our objective was to evaluate whether individuals actively involved in selecting their cancer surgeon were more likely to go to hospitals recognized for quality cancer care. Individuals diagnosed with breast, prostate and colorectal cancer in 2015 completed online surveys in 2017–2018. Participants were categorized as “directed” to a surgeon (relied on referral) or “active” (sought additional information), and hospitals were categorized by NCI-designation, CoC accreditation, and academic affiliation. Of 299 participants, 42% were active. Individuals with breast cancer were more active (aOR = 2.46,95%CI:1.32–4.59). Active participants had nonsignificantly higher odds of surgery at NCI-designated facilities (aOR = 2.04,95%CI:0.95–4.38), or academic centers (aOR = 1.51,95%CI:0.86–2.64). While most participants were directed to their cancer surgeon, active participants tended to select NCI-designated/academic hospitals. Although centralization of cancer care would require altering referral patterns, decision-support resources may help patients make informed choices. •Most cancer survivors were directed (e.g. referred) to a cancer surgeon.•A minority of participants were actively involved in selecting their cancer surgeon.•Breast cancer patients were more likely to be “active” in surgery decision-making.•“Active” patients may be more likely to get surgery at a large or accredited hospital.
Cancer surgery Decision-making High-volume hospitals Referral patterns Surgeon selection

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