Physicians' beliefs about the benefits and risks of adjuvant therapies for stage II and stage III colorectal cancer

Anthony C Wong; Shannon Stock; Deborah Schrag; Katherine L Kahn; Talya Salz; Mary E Charlton; Selwyn O Rogers Jr; Karyn A Goodman; Nancy L Keating

doi:10.1200/JOP.2013.001309

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Physicians' beliefs about the benefits and risks of adjuvant therapies for stage II and stage III colorectal cancer

Journal article

Open access

Peer reviewed

Physicians' beliefs about the benefits and risks of adjuvant therapies for stage II and stage III colorectal cancer

Anthony C Wong, Shannon Stock, Deborah Schrag, Katherine L Kahn, Talya Salz, Mary E Charlton, Selwyn O Rogers Jr, Karyn A Goodman and Nancy L Keating

Journal of oncology practice, Vol.10(5), pp.e360-e367

09/2014

DOI: 10.1200/JOP.2013.001309

PMCID: PMC4161733

PMID: 24986112

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Abstract

Adjuvant therapy plays a major role in treating colorectal cancer, and physicians' views of its effectiveness influence treatment decisions. We assessed physicians' views of the relative benefits and risks of adjuvant chemotherapy and radiotherapy for stages II and III colon and rectal cancers. The Cancer Care Outcomes Research and Surveillance Consortium surveyed a geographically dispersed population of medical oncologists, radiation oncologists, and surgeons in the United States about the benefits and risks of adjuvant therapies for colorectal cancer. We used logistic regression to assess the association of physician and practice characteristics with beliefs about adjuvant therapies. Among 1,296 respondents, > 90% believed the benefits of adjuvant therapies for stage III colorectal cancer outweigh the risks. Only 21.9%, 50%, and 50.4% believed in the net benefit of chemotherapy for stage II colon cancer, chemotherapy for stage II rectal cancer, and radiation for stage II rectal cancer, respectively. Younger physicians were less likely than others to perceive adjuvant therapy for stage II colorectal cancer as beneficial. Medical oncologists were more likely than surgeons and radiation oncologists to endorse the benefits of adjuvant chemotherapy and radiation for stage II rectal cancer, but less likely for stage II colon cancer. Physicians largely agreed that the benefits of adjuvant chemotherapy for stage III colon cancer, as well as chemotherapy, and radiation for stage III rectal cancer, outweigh the risks, consistent with strong evidence, but were divided over the net benefit of adjuvant therapies for stage II colorectal cancer, where evidence is inconsistent.

Geography

United States

Decision Making

Attitude of Health Personnel

Medical Oncology - methods

Physicians

Humans

Middle Aged

Logistic Models

Risk

Treatment Outcome

Combined Modality Therapy

Radiotherapy - adverse effects

Evidence-Based Medicine

Colorectal Neoplasms - therapy

Chemotherapy, Adjuvant - adverse effects

Adult

Aged

Neoplasm Staging

Odds Ratio

Details

Title: Subtitle: Physicians' beliefs about the benefits and risks of adjuvant therapies for stage II and stage III colorectal cancer
Creators: Anthony C Wong - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Shannon Stock - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Deborah Schrag - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Katherine L Kahn - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Talya Salz - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Mary E Charlton - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Selwyn O Rogers Jr - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Karyn A Goodman - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA goodmank@mskcc.org
Nancy L Keating - University of Chicago, Chicago, IL; College of the Holy Cross, Worcester, MA; Dana-Farber Cancer Institute; Brigham and Women's Hospital and Harvard Medical School, Boston, MA; RAND; University of California at Los Angeles, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Iowa College of Public Health; Veterans Affairs Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA; and Temple University School of Medicine, Philadelphia, PA
Resource Type: Journal article
Publication Details: Journal of oncology practice, Vol.10(5), pp.e360-e367
DOI: 10.1200/JOP.2013.001309
PMID: 24986112
PMCID: PMC4161733
NLM abbreviation: J Oncol Pract
ISSN: 1935-469X
eISSN: 1935-469X
Publisher: United States
Grant note: U01 CA093344 / NCI NIH HHS U01CA093339 / NCI NIH HHS U01 CA093326 / NCI NIH HHS U01 CA093324 / NCI NIH HHS U01 CA093339 / NCI NIH HHS U01 CA093348 / NCI NIH HHS U01CA093332 / NCI NIH HHS U01CA093348 / NCI NIH HHS U01CA093326 / NCI NIH HHS U01CA093324 / NCI NIH HHS U01 CA093329 / NCI NIH HHS P30 CA086862 / NCI NIH HHS U01 CA093332 / NCI NIH HHS U01CA093329 / NCI NIH HHS
Language: English
Date published: 09/2014
Academic Unit: Health Management and Policy; Epidemiology
Record Identifier: 9983995123802771

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