Referral patterns for suspected ovarian cancer: a survey of practicing gynecologists

We evaluated referral patterns for the initial surgery in patients with suspected ovarian cancer and factors associated with that referral. Through a mailed survey we asked gynecologists: (i) to rate the importance of characteristics of the patient, the mass, the surgeon and the hospital on to their decision to operate on or to refer to a gynecologic oncologist a patient with a pelvic mass; (ii) to indicate whether they would operate on or refer five hypothetical patients with masses of increasing complexity; (iii) to estimate on what proportion of patients with suspected ovarian cancer in their practice they currently operate; and (iv) to estimate the residual tumor volume when they perform surgery for ovarian cancer. Gynecologists seeing fewer patients with suspected ovarian cancers, in a teaching vs community hospital, in full-time university vs private practice and working in specific geographical areas, referred more to an oncologist for the primary surgery. Not significant were the gender of the surgeon, number of years in practice and distance to a regional cancer center. A high probability of cancer and characteristics of the surgeon affected referral patterns.