Journal article
Referrals and Decision-Making Considerations Involved in Selecting a Surgeon for Rectal Cancer Treatment in the Midwest United States
Diseases of the colon & rectum, Vol.65(7), pp.876-884
01/04/2022
DOI: 10.1097/DCR.0000000000002257
PMID: 35001047
Abstract
Despite evidence of superior outcomes for rectal cancer at high-volume, multi-disciplinary cancer centers, many patients undergo surgery in low-volume hospitals.
Examine former rectal cancer patients' considerations when selecting their surgeon, and evaluate which considerations were associated with surgery at high-volume hospitals.
We surveyed patients about what they considered when deciding on a cancer surgeon to complete this retrospective cohort study.
Study data were obtained via survey and the statewide Iowa Cancer Registry.
All eligible individuals diagnosed with invasive stages II/III rectal cancer from 2013-2017 identified through the registry were invited to participate.
The primary outcomes were the characteristics of the hospital where they received surgery (i.e., National Cancer Institute-designation, Commission on Cancer accreditation, and rectal cancer surgery volume).
There were 318 out of 417 (76%) completed surveys. Sixty-nine percent selected their surgeon based on their physician's referral/recommendation, 20% on surgeon/hospital reputation and 11% on personal connections to surgeon. Participants who chose their surgeon based on reputation had significantly higher odds of surgery at National Cancer Institute-designated (OR = 7.5, 95% CI: 3.8-15.0) or high-volume (OR = 2.6, 95% CI: 1.2-5.7) hospitals than those who relied on referral.
This study took place in a Midwestern state with a predominantly White population, which limited our ability to evaluate racial/ethnic associations.
Most rectal cancer patients relied on referrals in selecting their surgeon, and those who did were less likely to receive surgery at a National Cancer Institute-designated or high-volume hospitals compared to those who considered reputation. Future research is needed to determine the impact of these decision factors on clinical outcomes, patient satisfaction and quality of life. In addition, patients should be aware that relying on physician referral may not result in treatment from the most experienced or comprehensive care setting in their area. See Video Abstract at http://links.lww.com/DCR/B897.
Details
- Title: Subtitle
- Referrals and Decision-Making Considerations Involved in Selecting a Surgeon for Rectal Cancer Treatment in the Midwest United States
- Creators
- Natalie J Del Vecchio - Department of Epidemiology - University of Iowa College of Public Health, Iowa City, Iowa Department of Surgery - University of Iowa Hospitals and Clinics, Iowa City, Iowa Center for Access & Delivery Research and Evaluation, VA Office of Rural Health, Veterans Rural Health Resource Center - Iowa City VA Health Care System, Iowa City, Iowa Department of Internal Medicine - University of Iowa Hospitals and Clinics, Iowa City, Iowa Iowa Cancer Registry - University of Iowa, Iowa City, IowaXiang GaoKristin WeeksMichelle A MengelingAmanda R KahlIrena Gribovskaja-RuppCharles F LynchElizabeth ChrischillesMary E Charlton
- Resource Type
- Journal article
- Publication Details
- Diseases of the colon & rectum, Vol.65(7), pp.876-884
- DOI
- 10.1097/DCR.0000000000002257
- PMID
- 35001047
- NLM abbreviation
- Dis Colon Rectum
- eISSN
- 1530-0358
- Grant note
- T32 GM139776 / NIGMS NIH HHS
- Language
- English
- Electronic publication date
- 01/04/2022
- Academic Unit
- Pharmacy; Epidemiology; Surgery; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984214680702771
Metrics
19 Record Views