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Clinical Research

Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer

A Corrigendum to this article was published on 08 April 2014



Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL.


We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson’s chi-square and multivariable regression models were used to test for differences in each outcome.


Response rates were similar for radiation oncologists (52.6%) and urologists (52.3%; P=0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8–10 (35.2 vs 0.2%; P<0.001) to PSA 4–10 and Gleason score 7 (87.5 vs 20.9%; P<0.001). Radiation oncologists were also more likely to recommend radiation therapy relative to urologists (all P<0.001). From low- to high-risk prostate cancer, radiation oncologists and urologists perceived their treatment as being better for improving survival (all P<0.001). Each specialty also viewed their treatment as having less urinary incontinence (all P<0.001).


Radiation oncologists and urologists both prefer the treatment modalities they offer, perceive them to be more effective and to lead to a better QOL. Patients may be receiving biased information, and a truly informed consent process with shared decision-making may be possible only if they are evaluated by both specialties before deciding upon a treatment course.

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We thank Dr Floyd J Fowler for helping with the development of our survey for this study. This study was funded by The Robert Derzon Award from the Medical Decisions Foundation, Boston, MA, USA.

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Correspondence to S P Kim.

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Kim, S., Gross, C., Nguyen, P. et al. Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer. Prostate Cancer Prostatic Dis 17, 163–169 (2014).

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  • outcomes
  • quality of life
  • survey
  • treatment recommendations

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