Comparison of Recommendations by Urologists and Radiation Oncologists for Treatment of Clinically Localized Prostate Cancer
CONTEXT Multiple treatment options are available for men with prostate cancer, but therapeutic recommendations may differ depending on the type of specialist they consult. OBJECTIVE To define and contrast the distribution of management recommendations by urologists and radiation oncologists for a sp...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2000-06, Vol.283 (24), p.3217-3222 |
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| creator | Fowler, Jr, Floyd J McNaughton Collins, Mary Albertsen, Peter C Zietman, Anthony Elliott, Diana B Barry, Michael J |
| description | CONTEXT Multiple treatment options are available for men with prostate cancer,
but therapeutic recommendations may differ depending on the type of specialist
they consult. OBJECTIVE To define and contrast the distribution of management recommendations
by urologists and radiation oncologists for a spectrum of men with prostate
cancer. DESIGN, SETTING, AND PARTICIPANTS Mail survey sent in 1998 to a random sample of physicians in the United
States, who were listed as urologists (response rate 64%, n=504) and radiation
oncologists (response rate 76%, n=559) in the American Medical Association
Registry of Physicians and practicing at least 20 hours per week. MAIN OUTCOME MEASURE Questionnaire addressing beliefs and practices regarding prostate cancer
management. RESULTS Forty-three percent of radiation oncologists vs 16% of urologists would
recommend routine prostate-specific antigen testing for men aged 80 years
and older. For men with moderately differentiated, clinically localized cancers,
and a more than 10-year life expectancy, 93% of urologists chose radical prostatectomy
as the preferred treatment option, while 72% of radiation oncologists believed
surgery and external beam radiotherapy were equivalent treatments. For most
tumor grades and prostate-specific antigen levels, both specialty groups were
significantly more likely to recommend the treatment in their specialty than
the other treatment. Both groups reported giving patients similar estimates
of the risks of complications due to surgery and radiation. Neither group
favored watchful waiting in their treatment management except for a subset
of men with life expectancies of less than 10 years and cancers with very
favorable prognoses (Gleason score of 3 or 4 and prostate-specific antigen
level ≤5 ng/mL). CONCLUSIONS Based on this study, while urologists and radiation oncologists do agree
on a variety of issues regarding detection and treatment of prostate cancer,
specialists overwhelmingly recommend the therapy that they themselves deliver. |
| doi_str_mv | 10.1001/jama.283.24.3217 |
| format | Article |
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but therapeutic recommendations may differ depending on the type of specialist
they consult. OBJECTIVE To define and contrast the distribution of management recommendations
by urologists and radiation oncologists for a spectrum of men with prostate
cancer. DESIGN, SETTING, AND PARTICIPANTS Mail survey sent in 1998 to a random sample of physicians in the United
States, who were listed as urologists (response rate 64%, n=504) and radiation
oncologists (response rate 76%, n=559) in the American Medical Association
Registry of Physicians and practicing at least 20 hours per week. MAIN OUTCOME MEASURE Questionnaire addressing beliefs and practices regarding prostate cancer
management. RESULTS Forty-three percent of radiation oncologists vs 16% of urologists would
recommend routine prostate-specific antigen testing for men aged 80 years
and older. For men with moderately differentiated, clinically localized cancers,
and a more than 10-year life expectancy, 93% of urologists chose radical prostatectomy
as the preferred treatment option, while 72% of radiation oncologists believed
surgery and external beam radiotherapy were equivalent treatments. For most
tumor grades and prostate-specific antigen levels, both specialty groups were
significantly more likely to recommend the treatment in their specialty than
the other treatment. Both groups reported giving patients similar estimates
of the risks of complications due to surgery and radiation. Neither group
favored watchful waiting in their treatment management except for a subset
of men with life expectancies of less than 10 years and cancers with very
favorable prognoses (Gleason score of 3 or 4 and prostate-specific antigen
level ≤5 ng/mL). CONCLUSIONS Based on this study, while urologists and radiation oncologists do agree
on a variety of issues regarding detection and treatment of prostate cancer,
specialists overwhelmingly recommend the therapy that they themselves deliver.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.283.24.3217</identifier><identifier>PMID: 10866869</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Aged ; Antineoplastic agents ; Biological and medical sciences ; Brachytherapy ; Combined treatments (chemotherapy of immunotherapy associated with an other treatment) ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Physicians ; Practice Patterns, Physicians' - statistics & numerical data ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatectomy ; Prostatic Neoplasms - prevention & control ; Prostatic Neoplasms - radiotherapy ; Prostatic Neoplasms - surgery ; Questionnaires ; Radiation Oncology - statistics & numerical data ; Referral and Consultation ; Therapy ; United States ; Urology ; Urology - statistics & numerical data</subject><ispartof>JAMA : the journal of the American Medical Association, 2000-06, Vol.283 (24), p.3217-3222</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright American Medical Association Jun 28, 2000</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a436t-2ee672330fe8149d7c0f5747dd58f180b8895f61d8054502cec5572d054234a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.283.24.3217$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.283.24.3217$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76231,76234</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1402401$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10866869$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fowler, Jr, Floyd J</creatorcontrib><creatorcontrib>McNaughton Collins, Mary</creatorcontrib><creatorcontrib>Albertsen, Peter C</creatorcontrib><creatorcontrib>Zietman, Anthony</creatorcontrib><creatorcontrib>Elliott, Diana B</creatorcontrib><creatorcontrib>Barry, Michael J</creatorcontrib><title>Comparison of Recommendations by Urologists and Radiation Oncologists for Treatment of Clinically Localized Prostate Cancer</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Multiple treatment options are available for men with prostate cancer,
but therapeutic recommendations may differ depending on the type of specialist
they consult. OBJECTIVE To define and contrast the distribution of management recommendations
by urologists and radiation oncologists for a spectrum of men with prostate
cancer. DESIGN, SETTING, AND PARTICIPANTS Mail survey sent in 1998 to a random sample of physicians in the United
States, who were listed as urologists (response rate 64%, n=504) and radiation
oncologists (response rate 76%, n=559) in the American Medical Association
Registry of Physicians and practicing at least 20 hours per week. MAIN OUTCOME MEASURE Questionnaire addressing beliefs and practices regarding prostate cancer
management. RESULTS Forty-three percent of radiation oncologists vs 16% of urologists would
recommend routine prostate-specific antigen testing for men aged 80 years
and older. For men with moderately differentiated, clinically localized cancers,
and a more than 10-year life expectancy, 93% of urologists chose radical prostatectomy
as the preferred treatment option, while 72% of radiation oncologists believed
surgery and external beam radiotherapy were equivalent treatments. For most
tumor grades and prostate-specific antigen levels, both specialty groups were
significantly more likely to recommend the treatment in their specialty than
the other treatment. Both groups reported giving patients similar estimates
of the risks of complications due to surgery and radiation. Neither group
favored watchful waiting in their treatment management except for a subset
of men with life expectancies of less than 10 years and cancers with very
favorable prognoses (Gleason score of 3 or 4 and prostate-specific antigen
level ≤5 ng/mL). CONCLUSIONS Based on this study, while urologists and radiation oncologists do agree
on a variety of issues regarding detection and treatment of prostate cancer,
specialists overwhelmingly recommend the therapy that they themselves deliver.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Brachytherapy</subject><subject>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Physicians</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - prevention & control</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Questionnaires</subject><subject>Radiation Oncology - statistics & numerical data</subject><subject>Referral and Consultation</subject><subject>Therapy</subject><subject>United States</subject><subject>Urology</subject><subject>Urology - statistics & numerical data</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtLAzEQx4MotlbvepEg4m1rnpvsURZfUKiUel7STVZSdpOabA_VL2-01YJzGYb_b94AnGM0xgjh26Xq1JhIOiZsTAkWB2CIOZUZ5YU8BEOECpkJJtkAnMS4RMkwFcdggJHMc5kXQ_BZ-m6lgo3eQd_Amal91xmnVW-9i3Cxga_Bt_7Nxj5C5TScKW1_RDh19Z_S-ADnwag-5fbfhcrWOlurtt3AiU_efhgNX4KPveoNLJWrTTgFR41qoznb-RGYP9zPy6dsMn18Lu8mmWI07zNiTC4IpagxErNCixo1XDChNZcNlmghZcGbHGuJOOOI1KbmXBCdIkKZoiNwsy27Cv59bWJfdTbWpm2VM34dK4EJZgjJBF79A5d-HVwarSI4HY5jIhJ0uYPWi87oahVsp8Km-j1pAq53gIpp8SakXW3ccwwRlt4wAhdbLL1wLxZEph5fLlaOMg</recordid><startdate>20000628</startdate><enddate>20000628</enddate><creator>Fowler, Jr, Floyd J</creator><creator>McNaughton Collins, Mary</creator><creator>Albertsen, Peter C</creator><creator>Zietman, Anthony</creator><creator>Elliott, Diana B</creator><creator>Barry, Michael J</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20000628</creationdate><title>Comparison of Recommendations by Urologists and Radiation Oncologists for Treatment of Clinically Localized Prostate Cancer</title><author>Fowler, Jr, Floyd J ; McNaughton Collins, Mary ; Albertsen, Peter C ; Zietman, Anthony ; Elliott, Diana B ; Barry, Michael J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a436t-2ee672330fe8149d7c0f5747dd58f180b8895f61d8054502cec5572d054234a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Brachytherapy</topic><topic>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Physicians</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms - prevention & control</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Questionnaires</topic><topic>Radiation Oncology - statistics & numerical data</topic><topic>Referral and Consultation</topic><topic>Therapy</topic><topic>United States</topic><topic>Urology</topic><topic>Urology - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fowler, Jr, Floyd J</creatorcontrib><creatorcontrib>McNaughton Collins, Mary</creatorcontrib><creatorcontrib>Albertsen, Peter C</creatorcontrib><creatorcontrib>Zietman, Anthony</creatorcontrib><creatorcontrib>Elliott, Diana B</creatorcontrib><creatorcontrib>Barry, Michael J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fowler, Jr, Floyd J</au><au>McNaughton Collins, Mary</au><au>Albertsen, Peter C</au><au>Zietman, Anthony</au><au>Elliott, Diana B</au><au>Barry, Michael J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Recommendations by Urologists and Radiation Oncologists for Treatment of Clinically Localized Prostate Cancer</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2000-06-28</date><risdate>2000</risdate><volume>283</volume><issue>24</issue><spage>3217</spage><epage>3222</epage><pages>3217-3222</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Multiple treatment options are available for men with prostate cancer,
but therapeutic recommendations may differ depending on the type of specialist
they consult. OBJECTIVE To define and contrast the distribution of management recommendations
by urologists and radiation oncologists for a spectrum of men with prostate
cancer. DESIGN, SETTING, AND PARTICIPANTS Mail survey sent in 1998 to a random sample of physicians in the United
States, who were listed as urologists (response rate 64%, n=504) and radiation
oncologists (response rate 76%, n=559) in the American Medical Association
Registry of Physicians and practicing at least 20 hours per week. MAIN OUTCOME MEASURE Questionnaire addressing beliefs and practices regarding prostate cancer
management. RESULTS Forty-three percent of radiation oncologists vs 16% of urologists would
recommend routine prostate-specific antigen testing for men aged 80 years
and older. For men with moderately differentiated, clinically localized cancers,
and a more than 10-year life expectancy, 93% of urologists chose radical prostatectomy
as the preferred treatment option, while 72% of radiation oncologists believed
surgery and external beam radiotherapy were equivalent treatments. For most
tumor grades and prostate-specific antigen levels, both specialty groups were
significantly more likely to recommend the treatment in their specialty than
the other treatment. Both groups reported giving patients similar estimates
of the risks of complications due to surgery and radiation. Neither group
favored watchful waiting in their treatment management except for a subset
of men with life expectancies of less than 10 years and cancers with very
favorable prognoses (Gleason score of 3 or 4 and prostate-specific antigen
level ≤5 ng/mL). CONCLUSIONS Based on this study, while urologists and radiation oncologists do agree
on a variety of issues regarding detection and treatment of prostate cancer,
specialists overwhelmingly recommend the therapy that they themselves deliver.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>10866869</pmid><doi>10.1001/jama.283.24.3217</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2000-06, Vol.283 (24), p.3217-3222 |
| issn | 0098-7484 1538-3598 |
| language | eng |
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| source | MEDLINE; JAMA Network |
| subjects | Adult Aged Antineoplastic agents Biological and medical sciences Brachytherapy Combined treatments (chemotherapy of immunotherapy associated with an other treatment) Health Knowledge, Attitudes, Practice Humans Male Medical sciences Middle Aged Pharmacology. Drug treatments Physicians Practice Patterns, Physicians' - statistics & numerical data Prostate cancer Prostate-Specific Antigen - blood Prostatectomy Prostatic Neoplasms - prevention & control Prostatic Neoplasms - radiotherapy Prostatic Neoplasms - surgery Questionnaires Radiation Oncology - statistics & numerical data Referral and Consultation Therapy United States Urology Urology - statistics & numerical data |
| title | Comparison of Recommendations by Urologists and Radiation Oncologists for Treatment of Clinically Localized Prostate Cancer |
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