Standards for the management of cervical and vulval carcinoma

Referral patterns for gynaecologic cancers and precancerous conditions

OBJECTIVES

(1) To determine a gynaecologist's preference for delivering primary surgical care to women with gynaecologic cancer or precancerous conditions; (2) to determine referral patterns for gynaecologic cancers and precancerous conditions; (3) to outline barriers to the current gynaecologic oncology service provision in Ontario; (4) to understand, from a gynaecologist's perspective, the acceptable waiting times from referral to subspecialty consultation; and (5) to determine a gynaecologist's interest in following patients after more specialized management for gynaecologic cancer.

METHODS

The survey instrument was designed and pretested. The survey was mailed to 541 gynaecologists in Ontario.

RESULTS

The response rate was 49.4%. Of the gynaecologists who responded, 75.3% trained in Ontario; 57.3% had community-based practices; and 55% indicated they surgically treated women with invasive cancers. The invasive cases treated most commonly were endometrial cancer (96.4%), followed by ovarian cancer (86.1%). Ninety-one percent of gynaecologists referred their patients to the closest cancer centre with a gynaecologic oncologist on staff. Seventy-five percent of gynaecologists were interested in delivering follow-up care for women who had treatment for cancer, provided that follow-up guidelines were made available.

CONCLUSION

Gynaecologists were interested in providing follow-up care to women who received cancer care by subspecialists. Gynaecologists requested continuing education on gynaecologic cancers and guidelines for follow-up care. Issues surrounding the process of referral and communication with gynaecologists were seen as areas for improvement. The results of this survey will be pivotal in setting goals for a provincial gynaecologic oncology program.