title: Are the recommendations of the French consensus conference on the management of colon cancer followed up?
abstract: The aim of this study was to determine how the guidelines published after this conference have spread. Pretherapeutic evaluation and treatment were assessed for all colon cancers diagnosed in a well-defined French population in 2000. Patients were classified either as managed according to the recommendations, or as undermanaged or overmanaged. Outside the emergency context, pretherapeutic work-up was classified as in conformity with the consensus in 48.0% of the cases, as undervalued in 21.9% and as overvalued in 30.1%. The resection rate at 90% was not far from the optimum. Pathological data allowed us to classify nearly all cases according to the tumour node metastasis classification; however, the number of examined nodes was below the recommendations in 30.8% of cases. Chemotherapy was performed according to the recommendations in 71.4% of cases, 23.1% were undertreated and 5.5% were overtreated. The multivariate analysis indicates that patients aged 75 years or more were less likely to receive chemotherapy than was recommended (P<0.001). This study suggested that the main reasons for not following guideline recommendations were inertia due to previous practices, difficulty to perform a recommended behaviour and lack of familiarity.
authors.affiliation: University of Burgundy, Cancer Registry of Burgundy, INSERM EPI 0106, Dijon, France. come.lepage@u-bourgogne.fr
authors.forename: Côme
authors.initials: C
authors.lastname: Lepage
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bouvier
authors.forename: Christine
authors.initials: C
authors.lastname: Binquet
authors.forename: Vincent
authors.initials: V
authors.lastname: Dancourt
authors.forename: Olivier
authors.initials: O
authors.lastname: Coatmeur
authors.forename: Jean
authors.initials: J
authors.lastname: Faivre
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D003113:Colonoscopy / Q000706:statistics & numerical data; D003245:Consensus Statements as Topic; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006287:Health Planning Guidelines; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000628:therapy; D009367:Neoplasm Staging / Q000379:methods
chemical_list: D000970:Antineoplastic Agents