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  • 1
    Electronic Resource
    Electronic Resource
    Rural physicians' understanding of the state-of-the-art in breast, colon and rectum cancer treatment (1999)
    Springer
    Cancer causes & control 10 (1999), S. 261-267 
    Details
    ISSN: 1573-7225
    Keywords: breast neoplasms ; cancer treatment ; colonic neoplasms ; practice guidelines ; rural health care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: This study measured the impact of an educational intervention aimed at heightening rural physicians' awareness of state-of-the-art breast and colorectal cancer therapies. Methods: Pre- and post-intervention mailed surveys were administered to all primary-care physicians and referring physicians in the seven-county intervention region in North Carolina (NC) and a comparison region in South Carolina (SC). Results: The survey revealed few significant changes in physicians' perspectives that could be attributed to the intervention. Physicians erroneously stated that lumpectomy without follow-up radiation was acceptable for treating breast cancer (55%), failed to indicate that adjuvant therapy was an accepted practice for treating Stage I breast cancer (67%), failed to acknowledge chemotherapy as experimental for Dukes' B colon cancer patients (70%), and failed to recognize a combination of surgery, chemotherapy, and radiation as a standard treatment for rectal cancer (25%). Conclusions: The low levels of awareness of National Cancer Institute guidelines were reflected in low breast-sparing surgery rates for women living in the intervention region. Stronger consensus on appropriate cancer treatments is needed throughout the medical community in order to reduce undesired variation in rural, community-based cancer care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008996227202
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Rural breast cancer treatment: evidence from the Reaching Communities for Cancer Care (REACH) project (1999)
    Springer
    Breast cancer research and treatment 56 (1999), S. 59-66 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; neoplasm ; recommendations ; rural ; treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Research shows that rural populations are more likely than their urban counterparts to be diagnosed with late‐stage cancer, but less is known about appropriateness of cancer treatment in rural locations after diagnosis. The objective of this analysis was to assess the degree to which rural breast cancer treatment was received in concordance with national recommendations. Methods. Data came from 251 stage I and II breast cancer patients residing in rural North Carolina. State‐of‐the‐art care was defined using the National Cancer Institute's (NCI) physician data query (PDQ) database, and cases were categorized into appropriate primary and/or adjuvant treatment. Chi‐square and Fishers' exact tests were used to assess changes in appropriate treatment over time (1991–1996) and between stage. Multiple logistic regression was used to determine whether any patient or disease characteristics were associated with receipt of appropriate treatment. Results. Most (81–90%) of the breast cancer cases received the appropriate primary therapy (mastectomy or lumpectomy followed by radiation therapy); of these, the majority received a mastectomy (66–72%). Fewer women received adjuvant therapy as recommended (27–61%), although significantly more stage II than stage I cases did so (p≤0.05). Regression showed that stage and estrogen‐receptor (ER) status were associated with appropriate therapy. Conclusions. The findings suggest that there exist deviations from NCI established treatment recommendations among rural breast cancer patients. More research is needed to develop better methods for dissemination of state‐of‐the‐art cancer information to rural physicians and patients, and to understand how treatment decisions are made.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006279117650
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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