Different professionals' knowledge and perceptions of the management of people with pancreatic cancer

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Abstract

Background

Pancreatic cancer is generally associated with a very poor prognosis. The knowledge, beliefs and opinions of clinicians caring for people with pancreatic cancer may affect preferences for particular therapies and may impact upon patient outcomes. The aim of this study was to conduct a postal survey of clinicians who consult patients with pancreatic cancer to assess their knowledge regarding the disease itself and the effectiveness of various treatments, and to gauge their opinions regarding aspects of management.

Methods

A 20-item multiple-choice questionnaire was mailed to medical and radiation oncologists, gastroenterologists, general surgeons and hepatopancreatobiliary (HPB) surgeons in Australia. Questions assessed knowledge of survival following surgery for resectable disease, and survival and response rate following chemoradiation for locally advanced disease and chemotherapy for advanced disease. Beliefs regarding the need for tissue diagnosis and perceptions of benefit of various treatment strategies were also sought.

Results

Overall, knowledge was fair (average knowledge score 4.1 out of 8); 56% of HPB surgeons and 55% of medical oncologists had good knowledge, compared with 39% of gastroenterologists and general surgeons. There were marked differences in opinion regarding requirement for tissue diagnosis before further management. There was considerable variation in opinion regarding the benefit of postoperative adjuvant chemotherapy.

Conclusion

These findings argue strongly for the development of evidence-based guidelines. Multidisciplinary management teams may help educate individual clinicians and professional groups and are likely to result in improved outcomes for patients.

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