Knowledge, attitude, and practice toward total neoadjuvant therapy for rectal cancer among oncologists in China: A survey study

This cross-sectional survey study aimed to explore the knowledge, attitude, and practice (KAP) toward total neoadjuvant therapy (TNT) for rectal cancer (RC) among specialists in Hainan Province, China. RC specialists working in Hainan Province (China) were enrolled in this cross-sectional study between March and June 2023. A self-designed questionnaire was used to collect the participants' characteristics and KAP toward TNT for RC. A total of 279 valid questionnaires were collected. The KAP scores were 15.91 +/- 6.02 (possible range: 0-24), 34.16 +/- 5.11 (possible range: 10-50), and 12.42 +/- 1.83 (possible range: 3-15), respectively. The KAP scores of specialists who had applied TNT in clinical practice or research and had evaluated RC patients treated with TNT were significantly higher than those who had not (all P < 0.05). The structural equation model showed that knowledge of TNT directly affected attitude (beta = 0.292, P = 0.007) and practice (beta = 0.912, P = 0.007), and attitude toward TNT also had a direct effect on practice (beta = 1.047, P = 0.008). In conclusion, RC specialists in Hainan (China) had inadequate knowledge, negative attitudes, and sufficient practice toward TNT in Hainan Province, China. It is necessary to enhance education for RC specialists to improve their knowledge and attitude toward TNT.