Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer

Background: Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL. Methods: We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson’s chi-square and multivariable regression models were used to test for differences in each outcome. Results: Response rates were similar for radiation oncologists (52.6%) and urologists (52.3%; P =0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8–10 (35.2 vs 0.2%; P