Survey of Canadian doctors' attitudes to cancer staging.

OBJECTIVE: To collect opinions on the value of cancer staging, the impediments to realizing comprehensive staging and the support that may exist for providing stage information to cancer registries. DESIGN: The National Cancer Institute of Canada and the Canadian Committee on Cancer Staging have conducted an opinion survey. Opinions were sought about who should be responsible for allocating the stage, what criteria should be used to alter staging classification and whether population-based registries should contain comprehensive staging data. SETTING: The survey involved 1748 practising cancer specialists representing a cross section of Canadian physicians involved in the treatment and assessment of cancer patients. RESULTS: The overall response rate was 44.4%. Respondents gave broad support to the universal recording of cancer stage in Canada with 75.2% to 78.6% stating that staging is extremely useful for research, cancer statistics and caring for patients. Most respondents (98%) considered that all new cancer patients should have a specific stage assigned at the time of their first definitive treatment, and 78% believed that the clinician responsible for treating patients should determine the stage of cancer. A high proportion (73% to 81%) of respondents considered staging to be extremely important to define disease extent, make treatment decisions, estimate prognosis, facilitate consistent management and to compare results of treatment. The respondents consider lack of adequate information from pathology and imaging reports as barriers to staging. Only a small proportion of respondents were familiar with the organizations responsible for promoting and developing staging classifications. CONCLUSIONS: The Canadian survey showed strong support for universal staging and for the development of a central coordinated effort to promote cancer staging in Canada.