Physician Receptivity To Molecular Diagnostic Testing In Planning Treatment For Early-Stage Colon Cancer Patients

Abstract Molecular diagnostic testing is an emergent biomedical technology that can help physicians and patients make treatment decisions. We administered a survey questionnaire to surgeons and medical oncologists to assess physician receptivity to use of a molecular diagnostic test (GUCY2C) to identify early stage (pN0) colon cancer patients at risk for recurrence. We identified 104 physicians who treat such patients; and 43 (41%) physicians returned a completed survey. The survey included items on practice environment (e.g., hospital-versus community-based practice), physician background (e.g., sociodemographic characteristics), physician experience (exposure to pN0 colon cancer patients), and current practice for staging pN0 colon cancer patients (e.g., histopathology, molecular diagnostic testing). We also asked respondents to report how accurate (very accurate, somewhat accurate, not accurate) they thought histopathology and molecular diagnostic testing were in staging pN0 colon cancer patients. Items using a Likert-type response set (Strongly Disagree - 1 to Strongly Agree -5) were used to elicit responses to statements about stress related to making treatment recommendations, and confidence in recommending treatment. To measure the dependent variable, we used two items with the same type of response set, and asked physicians to indicate their readiness to incorporate GUCY2C testing into treatment planning. Responses were summed, averaged, and categorized into “Agree” (>3) and “Do Not Agree” (< = 3) categories. Frequencies and percentages for categorical variables, and means and standard deviation for continuous variables were determined. Fisher's Exact testing was used to assess statistically significant associations between categorical variables and the dependent variable; and the Wilcoxon test was used to identify continuous variable differences. Covariates at p < 0.2 were included in a multivariable logistic regression model. Overall, 56% of respondents were receptive to GUC2YC testing. Multivariable analyses show that physicians who thought that making treatment decisions was easy were significantly less receptive to GUCY2C testing than those who did not (OR = 0.04, CI: 0.004, 0.30); and, physicians who said they that would treat patients with an abnormal GUCY2C test result aggressively were significantly more receptive to GUCY2C testing (OR = 16.91, CI: 2.62, 109.11). Physician receptivity to molecular diagnostic testing was associated with uncertainty about treatment planning and readiness to act on test results. Citation Format: Ronald E. Myers, Thomas A. Wolf, Scott Waldman. Physician receptivity to molecular diagnostic testing in planning treatment for early-stage colon cancer patients. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 918. doi:10.1158/1538-7445.AM2015-918