B1
UK national survey on the use of Adjuvantonline as a decision making tool in early breast cancer (www.adjuvantonline.com)
Vijay Agarwal, Penny O'Neill
Castle Hill Hospital, Cottingham, UK
Background
Adjuvantonline enables us to predict 10-year relapse and mortality outcomes in patients with or without adjuvant chemotherapy and/or endocrine treatment assisting us in making decisions regarding adjuvant treatment. Recent NICE guidance has advocated the routine use of Adjuvantonline in early breast cancer.
Method
We contacted all cancer networks in England by email for a survey on the use of Adjuvantonline. Twenty-five replies were received from 13 oncology centers.
Results
Of the 25 responders, 24(96%) oncologists said they use Adjuvantonline in clinical practice and 1(4%) oncologist said no, but answered subsequent questions on its use. When asked the frequency of use, 10(40%) oncologists said they always (75-100%); 10(40%) said frequently (50-75%) and 5(20%) said sometimes (25-50%) use Adjuvantonline. When asked if they discussed the percentage of benefit with patients, 7(28%) said always; 9(36%) said frequently; 7(28%) said sometimes; 1(4%) said rarely (0-25%) and 1(4%) did not answer. Majority 12(48%) of the responders rarely, and none of them always, gave copies of the results to their patients. All the oncologists calculated outcome for mortality and 9(36%) calculated for both mortality and relapse. When asked as to at what percentage of mortality benefit they would discuss and recommend chemotherapy, the majority (60%) said they would discuss chemotherapy at 2-3% and recommend chemotherapy at 4-5%. When asked as to at what percentage of relapse benefit they would discuss and recommend chemotherapy, the majority (66.6%) said they would recommend chemotherapy at 10-20%.
Conclusion
There is great variability in the use of Adjuvantonline. Our survey showed that most of the Oncologists would calculate the outcomes for mortality benefit and would discuss chemotherapy with their patients for 2-3% benefit. As Adjuvantonline is designed to be used in conjunction with patients, it was surprising to see that majority rarely gave copies of the results to their patients.
