Mary E Charlton1, Lorren R Mattingly-Wells2, Jorge E Marcet3, Brenna C McMahon Waldschmidt4, John W Cromwell5. 1. Department of Epidemiology, University of Iowa College of Public Health, 145 N Riverside Drive, Iowa City, IA 52242, USA; VA Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA. Electronic address: mary-charlton@uiowa.edu. 2. Department of Nursing, VA Medical Center, Memphis, TN, USA. 3. Division of Colon and Rectal Surgery, Department of Surgery, University of South Florida, Tampa, FL, USA. 4. Department of Epidemiology, University of Iowa College of Public Health, 145 N Riverside Drive, Iowa City, IA 52242, USA. 5. Division of Gastrointestinal Surgery, Minimally Invasive and Bariatric Surgery, Department of Surgery, University of Iowa College of Medicine, Iowa City, IA, USA.
Abstract
BACKGROUND: 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. METHODS: Questionnaires on training, years of practice, and staging/treatment preferences were sent to surgeons practicing in Florida. RESULTS: 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. CONCLUSION: Increased focus on appropriate use of staging procedures and neoadjuvant CRT within general surgery training/educational programs is warranted.
BACKGROUND: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. METHODS: Questionnaires on training, years of practice, and staging/treatment preferences were sent to surgeons practicing in Florida. RESULTS: 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. CONCLUSION: Increased focus on appropriate use of staging procedures and neoadjuvant CRT within general surgery training/educational programs is warranted.
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