Mary E Charlton1,2, Ariana F Shahnazi3, Irena Gribovskaja-Rupp4, Lisa Hunter5, Michele A Mengeling6, Elizabeth A Chrischilles7, Charles F Lynch7,5, Marcia M Ward8. 1. Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Drive, Room S453 CPHB, Iowa City, IA, 52242, USA. mary-charlton@uiowa.edu. 2. Iowa Cancer Registry, University of Iowa College of Public Health, Iowa City, IA, USA. mary-charlton@uiowa.edu. 3. Department of Communications, University of Iowa College of Liberal Arts and Sciences, Iowa City, IA, USA. 4. Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA. 5. Iowa Cancer Registry, University of Iowa College of Public Health, Iowa City, IA, USA. 6. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA. 7. Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Drive, Room S453 CPHB, Iowa City, IA, 52242, USA. 8. Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA, USA.
Abstract
BACKGROUND: Current literature suggests surgeons who perform large volumes of rectal cancer resections achieve superior outcomes, but only about half of rectal cancer resections are performed by high-volume surgeons in comprehensive hospitals. Little is known about the 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. RESULTS: Fifteen survivors with an average age of 63 were interviewed: 60% were male, 53% resided in non-metropolitan areas, and 60% received surgery at low-volume facilities. Most patients considered surgeon volume and experience to be important determinants of outcomes, but few assessed it. Recommendation from a trusted source, usually a physician, appeared to be a main determinant of where patients received surgery. Patients who chose low-volume centers noted comfort and familiarity as important decision factors. CONCLUSION: Most rectal cancer patients in our sample relied on physician referrals to decide where to receive surgery. Interventions facilitating more informed decision-making by patients and referring providers may be warranted.
BACKGROUND: Current literature suggests surgeons who perform large volumes of rectal cancer resections achieve superior outcomes, but only about half of rectal cancer resections are performed by high-volume surgeons in comprehensive hospitals. Little is known about the 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. RESULTS: Fifteen survivors with an average age of 63 were interviewed: 60% were male, 53% resided in non-metropolitan areas, and 60% received surgery at low-volume facilities. Most patients considered surgeon volume and experience to be important determinants of outcomes, but few assessed it. Recommendation from a trusted source, usually a physician, appeared to be a main determinant of where patients received surgery. Patients who chose low-volume centers noted comfort and familiarity as important decision factors. CONCLUSION: Most rectal cancerpatients in our sample relied on physician referrals to decide where to receive surgery. Interventions facilitating more informed decision-making by patients and referring providers may be warranted.
Entities:
Keywords:
Patient decision making; Qualitative analysis; Rectal cancer
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