How Physician Age Affects Surveillance Intensity after Primary Ovarian Cancer Treatment
Akshar Y. Patel *
Department of Surgery, Saint Louis University Medical Center, St. Louis, MO, USA.
Anit K. Behera
Department of Surgery, Saint Louis University Medical Center, St. Louis, MO, USA.
Feng Gao
Department of Biostatistics, Washington University, St. Louis, MO, USA.
David G. Mutch
Department of Biostatistics, Washington University, St. Louis, MO, USA.
Katherine S. Virgo
Health Services Research, American Cancer Society, Atlanta, GA, USA.
Randall K. Gibb
Department of Biostatistics, Washington University, St. Louis, MO, USA.
Frank E. Johnson
Department of Surgery, Saint Louis University Medical Center, St. Louis, MO, USA and Department of Surgery, Veterans Affairs Medical Center, St. Louis, MO, USA.
*Author to whom correspondence should be addressed.
Abstract
Objective: We aimed to determine whether the variability in surveillance strategies after curative-intent primary treatment of ovarian cancer is related to practitioner age.
Materials and Methods: The 943 members of The Society of Gynecologic Oncology (SGO) were surveyed by conventional mail to quantify their surveillance strategies for patients with ovarian carcinoma after potentially curative initial treatment. We requested data regarding the recommended frequency of 10 commonly employed surveillance modalities. Age was used as a proxy for time since formal residency training.
Results: There were 283 responders: 58 were aged 30-39, 114 were aged 40-49, 70 were aged 50-59, and 41 were aged ≥ 60. Older gynecologic oncologists (60+) ordered office visits and pelvic examinations more frequently than younger gynecologic oncologists in year 1 (p<0.05). They ordered comprehensive metabolic panels more frequently during years 2-4 (p<0.05). They ordered CBCs more frequently during years 1-5 and year 10.
Conclusions: Although we had predicted that younger physicians would order surveillance tests more frequently than older physicians, we found the opposite. However, the differences attributable to age were clinically small. The results suggest that physician age does not account for a large portion of the known overall variation in the clinical practice of ovarian cancer patient surveillance after initial treatment. We propose that continuing medical education is a factor that can most plausibly explain this.
Keywords: Age, surveillance, ovarian, carcinoma, outcomes