Significant regional variation
Patients living in Edmonton were twice as likely to have a consultation with an oncologist after surgery as those living in Calgary or other parts of central or southern Alberta. Once a patient had a consult with an oncologist, however, region of residence was not associated with receiving chemotherapy.
"That points to the importance of co-ordination of care," added Winget.
Age was another factor, with 78 per cent of patients aged 75 and older not receiving treatment according to guidelines. Some 42 per cent were not referred to an oncologist.
"Just being 75 or older should not be a reason not to see an oncologist or not to get treatment. However, the data reflect the complexity in making treatment decisions in this age group," said Noha Sharaf El-din, a PhD candidate and co-author of the study.
Reasons for such results are likely multi-faceted, Sharaf El-din added. Older patients are more likely to have other diseases and ailments that could prevent them from being a candidate for chemotherapy. But even when factoring in other diseases, Winget's team found that age was still the largest factor in not receiving chemotherapy.
"The bottom line is there's variation in how individual oncologists perceive co-morbidities and age in a patient's ability to tolerate chemotherapy and be a chemo candidate," Winget said. "We wouldn't expect 100 per cent of rectal cancer patients to be medically eligible, but surely the number should be more than 50 per cent."
Winget said the overall results suggest that tighter co-ordination between surgeons and oncologists is needed, as is greater clarity regarding guidelines for colon and rectal cancer, which are similar diseases but are treated slightly differently.
She's taken the findings to the medical community to raise awareness and pro
|Contact: Bryan Alary|
University of Alberta