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Physician practice variation in head and neck cancer therapy: Results of a national survey

Author

Listed:
  • Fanny Cros

    (Service ORL, otoneurologie et ORL pédiatrique [CHU Toulouse] - Pôle Céphalique [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse)

  • Sébastien Lamy

    (Equipe EQUITY (CERPOP) - CERPOP - Centre d'Epidémiologie et de Recherche en santé des POPulations - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale, Registre général des cancers du Tarn = Tarn Cancer Registry - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse, ICR - Institut Claudius Regaud)

  • Pascale Grosclaude

    (Equipe EQUITY (CERPOP) - CERPOP - Centre d'Epidémiologie et de Recherche en santé des POPulations - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale, Registre général des cancers du Tarn = Tarn Cancer Registry - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse)

  • Antoine Nebout

    (ALISS - Alimentation et sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Emilien Chabrillac

    (Service ORL, otoneurologie et ORL pédiatrique [CHU Toulouse] - Pôle Céphalique [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse, IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale, ICR - Institut Claudius Regaud)

  • Sébastien Vergez

    (Service ORL, otoneurologie et ORL pédiatrique [CHU Toulouse] - Pôle Céphalique [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse)

  • Pierre Bories

    (IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Agnès Dupret-Bories

    (Service ORL, otoneurologie et ORL pédiatrique [CHU Toulouse] - Pôle Céphalique [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse, ICR - Institut Claudius Regaud, IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale)

Abstract

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.

Suggested Citation

  • Fanny Cros & Sébastien Lamy & Pascale Grosclaude & Antoine Nebout & Emilien Chabrillac & Sébastien Vergez & Pierre Bories & Agnès Dupret-Bories, 2021. "Physician practice variation in head and neck cancer therapy: Results of a national survey," Post-Print hal-03373358, HAL.
    • Handle: RePEc:hal:journl:hal-03373358
    DOI: 10.1016/j.oraloncology.2021.105293
    Note: View the original document on HAL open archive server: https://hal.inrae.fr/hal-03373358v1
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    References listed on IDEAS

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    2. Greenwald, H.P. & Polissar, N.L. & Borgatta, E.F. & McCorkle, R. & Goodman, G., 1998. "Social factors, treatment, and survival in early-stage non-small cell lung cancer," American Journal of Public Health, American Public Health Association, vol. 88(11), pages 1681-1684.
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