title: Rural physicians' understanding of the state-of-the-art in breast, colon and rectum cancer treatment.
abstract: OBJECTIVE
  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.
authors.affiliation: Cecil G. Sheps Center for Health Services Research, University of North Carolina-Chapel Hill, 27599, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Hatzell
authors.forename: T C
authors.initials: TC
authors.lastname: Ricketts
authors.forename: S E
authors.initials: SE
authors.lastname: Tropman
authors.forename: E D
authors.initials: ED
authors.lastname: Paskett
authors.forename: M R
authors.initials: MR
authors.lastname: Cooper
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D002983:Clinical Competence; D003110:Colonic Neoplasms / Q000628:therapy*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards; D012004:Rectal Neoplasms / Q000628:therapy*; D019035:Rural Health Services / Q000592:standards; D013022:South Carolina; D011795:Surveys and Questionnaires