ATTITUDES OF NON-ONCOLOGY PHYSICIANS DEALING WITH CANCER-PATIENTS - ASURVEY BASED ON CLINICAL SCENARIOS IN ANCONA PROVINCE, CENTRAL ITALY

Aims and Background: With this study we attempted to determine to what extent recent acquisitions in clinical oncology had reached categorie s of physicians involved in the management of patients with cancer, na mely general surgeons, internists and family doctors. Methods: A quest ionnaire was prepared with scenarios based on the following clinical s ituations: Scenario A, Adjuvant therapy in colon cancer; Scenario B, T reatment of small-cell lung cancer; Scenario C, Adjuvant therapy in hi gh-risk, node-negative breast cancer; Scenario D, Treatment of early s tage breast cancer; Scenario E, Asymptomatic transient myelosuppressio n during chemotherapy. Questionnaires were mailed to 365 family doctor s, 54 general surgeons and 61 internists of the Province of Ancona in central Italy. Results: A total of 198 completed questionnaires were r eturned (41%). Respondents were 36.7% of family doctors, 54.1% of inte rnists and 57.4% of surgeons. Less than half of respondents selected a n adequate approach such as adjuvant chemotherapy for colon cancer and high-risk, node-negative breast cancer or chemotherapy as first-line treatment for small-cell lung cancer. Conservative surgery plus radiot herapy (QUART) for early stage breast cancer was indicated by 69% of r espondents. Over three quarters of physicians would give treatment for asymptomatic transient chemotherapy-induced leukopenia. In most of th e scenarios, significant differences were detected in the distribution of preferences according to category of physicians. Family doctors an d young physicians (<40 years) generally performed worse than hospital -based physicians (general surgeons and internists) and older physicia ns. Conclusions: Non-oncology physicians showed insufficient awareness of currently available knowledge in cancer treatment. Basic concepts in cancer management should be part of the professional knowledge of a ll medical doctors, and key advances in clinical oncology should sprea d outside the oncologic environment more promptly, with a wide circula tion among all physicians who care for cancer patients.