title: Self-reported practice patterns and knowledge of rectal cancer care among Canadian general surgeons.
abstract: BACKGROUND
  Our objective was to examine the knowledge and treatment decision practice patterns of Canadian surgeons who treat patients with rectal cancer.
  
  
  METHODS
  A mail survey with 6 questions on staging investigations, management of low rectal cancer, lymph node harvest, surgical margins and use of adjuvant therapies was sent to all general surgeons in Canada. Appropriate responses to survey questions were defined a priori. We compared survey responses according to surgeon training (colorectal/surgical oncology v. others) and geographic region (Atlantic, Central, West).
  
  
  RESULTS
  The survey was sent to 2143 general surgeons; of the 1312 respondents, 703 treat patients with rectal cancer. Most surgeons responded appropriately to the questions regarding staging investigations (88%) and management of low rectal cancer (88%). Only 55% of surgeons correctly identified the recommended lymph node harvest as 12 or more nodes, 45% identified 5 cm as the recommended distal margin for upper rectal cancer, and 70% appropriately identified which patients should be referred for adjuvant therapy. Surgeons with subspecialty training were significantly more likely to provide correct responses to all of the survey questions than other surgeons. There was limited variation in responses according to geographic region. Subspecialty-trained surgeons and recent graduates were more likely to answer all of the survey questions correctly than other surgeons.
  
  
  CONCLUSIONS
  Initiatives are needed to ensure that all surgeons who treat patients with rectal cancer, regardless of training, maintain a thorough and accurate knowledge of rectal cancer treatment issues.
authors.affiliation: The Division of General Surgery, Dalhousie University, Halifax, NS.
authors.forename: Devon P
authors.initials: DP
authors.lastname: Richardson
authors.affiliation: The Division of General Surgery and Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS.
authors.forename: Geoff A
authors.initials: GA
authors.lastname: Porter
authors.affiliation: The Division of General Surgery and Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D002983:Clinical Competence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000628:therapy*; D057566:Self Report; D066231:Surgeons / Q000592:standards* / Q000706:statistics & numerical data