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- handle: 10670/1.jppzid
- hal: hal-03373358
- doi: 10.1016/j.oraloncology.2021.105293
- PII: S1368-8375(21)00116-0
- PUBMED: 33862559
- WOS: 000663091700005
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info:eu-repo/semantics/altIdentifier/doi/10.1016/j.oraloncology.2021.105293
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info:eu-repo/semantics/altIdentifier/pmid/33862559
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Mots-clés
Head and neck oncology Medical decision-making National survey Patients' socioeconomic status Practitioners' specialtySujets proches
Diseases--Surgery Surgery, PrimitiveCiter ce document
Fanny Cros et al., « Physician practice variation in head and neck cancer therapy: Results of a national survey », HAL-SHS : économie et finance, ID : 10.1016/j.oraloncology.2021.105293
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Objectives: Choice between surgical or medical treatments in head and neck cancer depends of many patient-related and disease-related factors. We investigated how patients' socioeconomic status and practitioners' specialty could affect medical decision-making.Materials and methods: We conducted a cross-sectional online, nationwide survey, send to surgeons, oncologists and radiotherapists specialized in head and neck oncology. We collected data on medical decision-making for seven clinical scientific scenarios involving head and neck carcinoma and physicians' demographic data. Patients' gender and socioeconomic position were distributed across scientific scenarios using a Latin square design. The scientific scenarios were grouped into several categories according to the prognostic and functional impact of the therapeutic choice.Results: We obtained 206 assessable answers. Surgeons seemed to propose surgery in 49% of cases, whereas oncologists and radiotherapists opted for it in 34% of cases only. This was particularly relevant when the oncological result of surgery and the medical approach were equivalent, and when the surgery appeared to be superior in terms of curative potential but was burdened by a large functional impact. Patient's socioeconomic position also influence therapeutic decision. Among surgeons, the "single male manager" had significantly more chance of being offered surgery than the "married male blue-collar worker". Among oncologists and radiotherapists, the "single male blue-collar worker" had the lowest probability of being proposed surgery. Regarding gender, surgeons tended to offer surgical management more to women regardless of their clinical profile.Conclusions: Patients' sex, marital status, socioeconomic status, practitioners' specialty affect therapeutic management decisions in head and neck oncology.