Welcome to CDC stacks | Oncologists’ influence on receipt of adjuvant chemotherapy: Does it matter whom you see for treatment of curable breast cancer? - 59502 | CDC Public Access

Welcome to CDC stacks | Oncologists’ influence on receipt of adjuvant chemotherapy: Does it matter whom you see for treatment of curable breast cancer? - 59502 | CDC Public Access

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Oncologists’ influence on receipt of adjuvant chemotherapy: Does it matter whom you see for treatment of curable breast cancer?

Published Date:

Jul 08 2017

Source:

Breast Cancer Res Treat. 165(3):751-756.

Language:

English

[PDF-1.06 MB]

Details:

Personal Authors:

Katz, Steven J. ; Hawley, Sarah T. ; Bondarenko, Irina ; Jagsi, Reshma ; Ward, Kevin C. ; ... More ▼

Keywords:

[+]

Pubmed ID:

28689364

Pubmed Central ID:

PMC5709196

Description:

Purpose

We know little about whether it matters which oncologist a breast cancer patient sees with regard to receipt of chemotherapy. We examined oncologists’ influence on use of recurrence score (RS) testing and chemotherapy in the community.

Methods

We identified 7,810 women with stages 0-II breast cancer treated in 2013–15 through the SEER registries of Georgia and Los Angeles County. Surveys were sent 2 months post-surgery, (70% response rate, n=5,080). Patients identified their oncologists (n=504) of whom 304 responded to surveys (60%). We conducted multi-level analyses on patients with ER positive HER2 negative invasive disease (N=2973) to examine oncologists’ influence on variation in RS testing and chemotherapy receipt, using patient and oncologist survey responses merged to SEER data.

Results

Half of patients (52.8%) received RS testing and 27.7% chemotherapy. One-third (35.9%) of oncologists treated >50 new breast cancer patients annually; mean years in practice was 15.8. Oncologists explained 17% of the variation in RS testing but little of the variation in chemotherapy receipt (3%) controlling for clinical factors. Patients seeing an oncologist who was one standard deviation above the mean use of RS testing had over two-times higher odds of receiving RS (2.47, 95% CI 1.47–4.15), but a parallel estimate of the association of oncologist with the odds of receiving chemotherapy was much smaller (1.39, CI 1.03–1.88).

Conclusions

Clinical algorithms have markedly reduced variation in chemotherapy use across oncologists. Oncologists’ large influence on variation in RS use suggests that they variably seek tumor profiling to inform treatment decisions.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

HHSN261201000140C/CA/NCI NIH HHS/United States
5NU58DP003862-04/DP003862/Centers for Disease Control and Prevention/
HHSN261201000035C/CA/NCI NIH HHS/United States
P01 CA163233/CA/NCI NIH HHS/United States
U58 DP003875/DP/NCCDPHP CDC HHS/United States
HHSN261201000140C/National Cancer Institute/
5NU58DP003875-04-00/Centers for Disease Control and Prevention/
HHSN261201300015C/RC/CCR NIH HHS/United States
P01CA163233/National Cancer Institute/
HHSN261201000034C/National Cancer Institute/
HHSN261201300015I/HHSN26100006/National Cancer Institute/
HHSN261201000035I/CA/NCI NIH HHS/United States
HHSN261201000034C/CA/NCI NIH HHS/United States
U58 DP003862/DP/NCCDPHP CDC HHS/United States
HHSN261201000035C/National Cancer Institute/

Main Document Checksum:

[+]

Supporting Files:

	NIHMS891533-supplement-10549_2017_4377_MOESM1_ESM.tif	image/tiff
	nihms891533.nxml	text/xml
	nihms891533f1.gif	image/gif
	nihms891533f1.jpg	image/jpeg
	nihms891533f2.gif	image/gif
	nihms891533f2.jpg	image/jpeg

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