Treatment options for perianal Bowen's disease: Survey of American Societyof Colon and Rectal Surgeons members

The aim of this study was to determine current management practices of phys icians caring for patients with perianal Bowen's disease. A questionnaire w as sent to 1499 members listed in the 1997 American Society of Colon and Re ctal Surgeons Directory asking them how many patients they have treated and which operative or nonoperative treatment option they choose for small (le ss than or equal to 3 cm), large (> 3 cm), and microscopic lesions. Of 1499 , 663 (44.2%) surgeons responded. Not all respondents answered each item. S eventy-five per cent of surgeons surveyed (n = 653) devote greater than 75 per cent of their practice to colon and rectal surgery. Of 642 respondents, 552 (86%) managed a total of <10 patients, and 90/642 (14%), greater than or equal to 10 patients. Ninety-six per cent of respondents use wide local excision for patients with small lesions. Eighty-seven per cent of responde nts use wide local excision for patients with large lesions. Seventy-four p er cent treat patients with microscopic disease conservatively and without wide excision. The majority of surgeons caring for patients with perianal B owen's disease are performing wide local excision for both small and large lesions. Microscopic disease was usually treated conservatively with observ ation alone.