Journal article
Qualitative analysis of Iowa rectal cancer patients’ decisions on where to receive surgery
Journal of clinical oncology, Vol.36(4_suppl), pp.835-835
02/01/2018
DOI: 10.1200/JCO.2018.36.4_suppl.835
Abstract
835 Background: Current literature suggests surgeons and hospitals that perform large volumes of rectal cancer care achieve superior outcomes, but only about half of rectal cancer resections are performed by high-volume surgeons in comprehensive hospitals. Little is known about considerations of patients with rectal cancer when deciding where to receive surgery. Methods: A purposive sample of stage II/III rectal adenocarcinoma survivors diagnosed 2013-2015 were identified through the Iowa Cancer Registry and interviewed by telephone about factors influencing decisions on where to receive rectal cancer surgery. Interviews were recorded and transcribed, and a thematic analysis was conducted. Results: Thematic saturation was reached after interviewing 15 survivors. Mean age was 63; 60% were male, 53% resided in non-metropolitan areas and 60% received surgery at low-volume centers. Recommendation from a trusted source, usually a physician, appeared to be a main driver of where patients received surgery. Patients who chose high-volume centers were directed by a trusted source to seek care there, whereas patients who chose low-volume centers described valuing hospitals that were closer to home, knowing individuals at the hospital and receiving prior care there, and being familiar with others who received care from a specific surgeon. Most considered surgeon volume and experience to be important determinants of outcomes, but few actually assessed it. Most characterized surgeon experience based on subjective assessments including interpersonal skills, ability to explain procedures and perceived surgeon confidence. Several reported not trusting online sources for treatment information. Conclusions: Most rectal cancer patients in our sample relied on physician referrals to decide where to receive surgery. Further research is needed to determine rectal cancer patients’ preferences for obtaining information about surgeon/hospital volume and experience since our findings suggest they are neither discussing these factors with their surgeon nor researching them on their own. Once preferences are determined, targeted interventions facilitating more informed decision-making by patients can be developed.
Details
- Title: Subtitle
- Qualitative analysis of Iowa rectal cancer patients’ decisions on where to receive surgery
- Creators
- Mary E Charlton - University of Iowa College of Public Health, Iowa City, IAAriana Shahnazi - University of Iowa, Iowa City, IAIrena Gribovskaja-Rupp - University of Iowa Carver College of Medicine, Iowa City, IAChi Lin - University of Nebraska Medical Center, Omaha, NELisa Hunter - University of Iowa College of Public Health, Iowa City, IAElizabeth A Chrischilles - University of Iowa College of Public Health, Iowa City, IACharles F Lynch - University of Iowa, Iowa City, IAMarcia M Ward - University of Iowa College of Public Health, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.36(4_suppl), pp.835-835
- DOI
- 10.1200/JCO.2018.36.4_suppl.835
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 02/01/2018
- Academic Unit
- Epidemiology; Surgery; Health Management and Policy; Pharmacy
- Record Identifier
- 9984214707402771
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