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Physicians’ attitudes and perceived barriers to adherence to the national breast cancer clinical practice guidelines in Mexico: a survey study

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Abstract

Background

Adherence to clinical practice guidelines improves outcomes for patients with breast cancer. However, their implementation may not be feasible in low- and middle-income countries. This study aimed to evaluate physicians’ adherence, attitudes, and barriers towards the Colima Consensus, which is the Mexican national breast cancer clinical practice guideline.

Methods

A cross-sectional, 31-item survey was e-mailed to Consensus attendees and members of the Mexican Society of Oncology and Mexican Mastology Association. Descriptive statistics, univariate, and multivariate analysis were used to analyze the associations between participants’ characteristics, adherence, attitudes, and barriers.

Results

Of 439 respondents, 78% percent adhered to Consensus recommendations and 94% believed it was applicable to their clinical practice. Forty percent reported using the Consensus as their sole breast cancer guideline. This was associated with being a surgical oncologist (OR 3.3, 95% CI 2.0–5.3) and practicing at a public hospital (OR 2.1, 95% CI 1.2–3.7). The most common barriers to adherence were lack of resources and logistical problems. Regarding attitudes towards the Consensus, 90% considered it a good educational tool, 89% considered it a reliable source of information, and 90% thought it improved quality of care.

Conclusions

We showed high levels of adherence and positive attitudes towards the Colima Consensus, with a significant proportion of physicians using it as their only guideline. Lack of resources and logistical issues were the main barriers to adherence. Our results highlight the relevance of local breast cancer guidelines and suggest a need for the creation of resource-stratified guidelines.

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Acknowledgements

We wish to dedicate this manuscript in memory of Dr. Aura Erazo Valle-Solis, founder of the Colima Consensus, who passed away on May 23rd, 2022.

Funding

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Author information

Authors and Affiliations

  1. Hematology-Oncology Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico

    Bertha Alejandra Martinez-Cannon

  2. Department of Geriatrics, Cancer Care in the Elderly Clinic, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubiran, Vasco de Quiroga 15, Belisario Dominguez Secc 16, Tlalpan, 14080, Mexico City, Mexico

    Enrique Soto-Perez-de-Celis

  3. Neoplastic and Proliferative Disorders Division, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico

    Aura Erazo Valle-Solis

  4. Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Mexico City, Mexico

    Claudia Arce-Salinas & Enrique Bargallo-Rocha

  5. Instituto de Enfermedades de la Mama FUCAM, Mexico City, Mexico

    Veronica Bautista-Piña

  6. Department of Medical Oncology, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico

    Guadalupe Cervantes-Sanchez & Laura Torrecillas Torres

  7. Radiotherapy and Medical Physics Service, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico

    Christian Haydeé Flores-Balcázar

  8. Breast Imaging, CT Scanner del Sur, Mexico City, Mexico

    Maria del Carmen Lara Tamburrino

  9. Medical Oncology Unit, Centro de Investigacion Biomedica en Red de OncologiaGEICAM Spanish Breast Cancer Group, Hospital Clinico Universitario de Valencia, Biomedical Research Institute INCLIVA, Universidad de Valencia, CIBERONC-ISCIII, Valencia, Spain

    Ana Lluch

  10. Department of Surgical Oncology, American British Cowdray Medical Center, Mexico City, Mexico

    Antonio Maffuz-Aziz

  11. Department of Surgical Pathology, Instituto Nacional de Cancerologia, Mexico City, Mexico

    Victor Manuel Pérez-Sánchez

  12. Department of Radiation Oncology, Medica SUR, Mexico City, Mexico

    Adela Poitevin-Chacón

  13. Hospital de Gineco-Obstetricia, Centro Médico Nacional de Occidente IMSS, Guadalajara, Mexico

    Efraín Salas-González

  14. Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Vicente Valero

  15. Subdireccion de Servicios Auxiliares de Diagnostico Y Tratamiento, Instituto Nacional de Cancerologia, Mexico City, Mexico

    Yolanda Villaseñor-Navarro

  16. Instituto Estatal de Cancerologia, Colima, Mexico

    Jesús Cárdenas-Sánchez

Authors
  1. Bertha Alejandra Martinez-Cannon
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  2. Enrique Soto-Perez-de-Celis
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  3. Aura Erazo Valle-Solis
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  18. Jesús Cárdenas-Sánchez
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Corresponding author

Correspondence to Enrique Soto-Perez-de-Celis.

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Martinez-Cannon, B., Soto-Perez-de-Celis, E., Erazo Valle-Solis, A. et al. Physicians’ attitudes and perceived barriers to adherence to the national breast cancer clinical practice guidelines in Mexico: a survey study. Clin Transl Oncol 25, 151–159 (2023). https://doi.org/10.1007/s12094-022-02921-9

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