Adjuvant therapy for XXXX : practice patterns of community physicians.

@entity1 @entity440 @entity0 @entity5 @entity1817
PURPOSE: We evaluated the use of adjuvant therapy for @entity0 using the National Institutes of Health (NIH) Consensus Development Conference statements as guideposts for assessing how rapidly community physicians adopt recommended therapies. @entity1 AND METHODS: @entity1 with stage I through IIIA @entity0 diagnosed in 1987 through 1991 and in 1995 were randomly sampled from the population-based National @entity5 Institute Surveillance, Epidemiology, and End-Results program. A total of 8,106 @entity1 were included in the study with younger @entity1 , < or = 50 years, being oversampled. Their treating physicians were asked to verify whether chemotherapy, hormonal therapy, or both were given. RESULTS: After adjusting for clinical and nonclinical factors, the use of 1985 recommendations for adjuvant therapy in @entity1 with @entity1817 was already high at 80% in 1987 and increased slightly to 84% by 1995. Use of combined multidrug chemotherapy plus @entity440 increased. In contrast, the use of 1990 recommendations for adjuvant therapy for node-negative disease was slightly less than 13% in 1987 and increased markedly to 57% by 1995. For @entity1 with node-negative @entity5 > or = 1 cm in size diagnosed in 1995, 40% received @entity440 , 16% combination chemotherapy, and 7% both, an increase from 10%, 5%, and 0.4%, respectively, in 1987. CONCLUSION: Community physicians began prescribing adjuvant chemotherapy and hormonal therapy in advance of publication of the NIH consensus statement in 1990. Adoption of recommended treatments for node-negative disease has been less complete compared with node-positive @entity5 , perhaps reflecting the more complex nature of the clinical trials data or the smaller anticipated benefit from adjuvant therapy for this disease subset.
