Key result
Higher education is linked to lower decision regret after colorectal and oesophageal cancer surgery.
Why the study?
Undergoing major cancer surgery is an important decision for patients, but the effectiveness of decision-making following colorectal and oesophageal cancer surgery required assessment.
Patients undergoing curative surgery for gastrointestinal malignancies report low decisional regret and high confidence in pre-operative decision-making, though those with longer hospital stays or lower quality of life may experience more decisional conflict.
May warrant education-tailored decision aids in GI cancer surgery; extends prior evidence but should not yet change practice.
Abstract Aim Undergoing major cancer surgery is an important decision for patients. This study assessed the effectiveness of decision-making following colorectal and oesophageal cancer surgery. Methods Patients who had undergone colorectal and oesophageal cancer surgery in two UK centres over two years were identified. Validated patient reported outcomes (PROs) were collected by cross sectional survey including perceived confidence in decision-making and effectiveness of risk communication (COMRADE scale), decision regret (Decisional Conflict Score; DCS), and quality of life (EORTC QLQ-PAL15). Uni-variable linear regression was used to explore the relationship between PRO scores and clinical and sociodemographic variables. Results Some 143/244 (58%) patients returned the questionnaire. Overall, decision regret was low (median 7.81, range 0–23.4), and perceived confidence in decision-making and effectiveness of risk communication was good (median 95 (75–100) and 85 (70–100) respectively). Higher education level was associated with reduced regret (−0.7; CI −1.2 to −0.1;p = 0.016) and a longer length of hospital stay was associated with higher regret (1;CI 0.2–1.9;p = 0.014). Conclusion Patients perceived decision-making to be effective in this study, but those with adverse outcomes may benefit from further support.
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Lawday et al. (2026) studied this question. Perceived confidence in decision-making was high (median 95) among patients post-colorectal and oesophageal cancer surgery, but higher education was linked to lower decision regret.
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