| Abstract: | The relative frequency of consultation of the different specialists involved in the diagnosis and treatment of cancer is not well known in France. This study was completed with data collected by the Digestive Tract Cancer Registry in C?te d'Or. Among 3.192 digestive tract cancers diagnosed between 1976 and 1982, 64 p. 100 were treated by gastroenterologists or surgeons. Only 18% of the patients consulted an oncologist. The frequency of consultation of gastroenterologists in the care of digestive tract cancers was independent on the location of the cancer but varied with the place of residence, fluctuating from 69.7% for patients living in the town of Dijon, to 39.9% for patients living in a town with a regional hospital without gastroenterologist. The inverse phenomenon was observed for oncologists. They treated 63.2% of the patients with esophageal cancer and 31.2 p. 100 of patients with rectal cancer, but less than 10 p. 100 of the patients with gastric, colonic, liver, biliary tract or pancreatic cancer. The number of surgeons consulted depended essentially on the operability of the cancer. Between 1976 and 1982 consultation with gastroenterologists and surgeons by patients with digestive tract cancer increased by 4.4 p. 100 (p less than 0.05) and 2.1 p. 100 per year (p less than 0.01), respectively. The frequency of consultation of oncologists remained stable: +0.3 p. 100 per year. These results confirm the importance of a training policy oriented towards specialists who are not oncologists. They must take note of their importance in the diagnosis and the organization of the fight against digestive tract cancers. |
