How practice patterns in lung cancer patient follow-up are affected by surgeon age

Strategies for the follow-up of lung cancer patients after potentially curative treatment are known to vary widely. The optimal regimen remains unknown. We investigated whether the age of the surgeon affects choice of surveillance strategy. The 3,700 members of the Society of Thoracic Surgeons (STS) were surveyed using a detailed questionnaire to measure how these surgical experts deal with lung cancer patient follow-up. Subjects were asked how they use 10 specific follow-up modalities during years 1-5 following primary treatment for patients with lung cancer (TNM stages I-III). Repeated-measures analysis of variance was used to compare practice patterns by surgeon age, as well as by TNM stage and year post-surgery. Evaluable responses from 768 STS members (21%) were received. Follow-up strategies for most of the ten modalities were highly correlated across TNM stages and years post-surgery, as expected. The pattern of testing varied significantly by surgeon age for only one modality (LFTs). Even in this instance, the absolute differences in surveillance strategies among age groups were small. This analysis indicates that the post-treatment surveillance practice patterns of surgeons caring for patients with lung cancer do not vary substantially with practitioner age. The data provide credible evidence that post-graduate education is effective in homogenizing practitioner behavior.