Dukes' staging is poorly understood by doctors managing colorectal cancer.
OBJECTIVE
This study set out to investigate the current understanding of Dukes' staging for colorectal cancer.


METHODS
A questionnaire was distributed to surgeons and general practitioners attending colorectal meetings asking for a definition of Dukes' stages A, B and C. Results were analysed blind by two authors jointly to assess accuracy as correct, within definition, or incorrect. Within definition was defined as a description fitting within but not covering all tumours within that stage.


RESULTS
128 answers were received from 48 GPs, 7 final year medical students, 38 house officers and SHOs, 19 higher surgical trainees and 16 consultants. Overall, 3.9% defined all three stages correctly and 13.3% got all three definitions incorrect. Correct stages were Dukes' A 7.8%, Dukes' B 16.4% and Dukes' C 29.7%. Two consultants (12.5%) achieved three correct definitions, as did two HSTs (10.5%). No GPs had all three stages correct and 10 (20.8%) were wrong in all three. If those said to be within definition were considered right, 35.1% were correct for all three stages with 76.6% getting Dukes' A correct, 46.9% Dukes' B and 56.6% Dukes' C.


CONCLUSIONS
Dukes' staging is, therefore, still poorly understood by doctors managing patients with colorectal cancer. The introduction of proformas will reduce the reliability upon memory for this and more complex staging classifications.
Mainprize
K S
KS
Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK. karl@mainprize.net
Mortensen
N J Mc C
NJ
Warren
B F
BF
D002983:Clinical Competence; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D003253:Consultants; D005194:Family Practice / Q000592:standards*; D013502:General Surgery / Q000592:standards*; D006801:Humans; D008505:Medical Staff, Hospital / Q000592:standards; D009367:Neoplasm Staging; D013337:Students, Medical; D011795:Surveys and Questionnaires