Knowledge, attitude, and practice of cardio-oncology amongst oncologists and cardiologists of south-east Asia: An Asian Cardio-Oncology Society (ACOS) survey.

Abstract

e24019 Background: Asian Cardio Oncology Society (ACOS) was started in 2020 to promote awareness regarding cardio-oncology in south-eastern Asia. This study describes our baseline survey on knowledge, attitude and practice (KAP) of cardio-oncology amongst cardiologists & oncologists of India and south-east Asia. Methods: A 38-question survey was administered online via google forms using email and watsapp to contact members of ACOS and other cardiologists/oncologists in south-east Asia from December 2020 to January 2021. Results: Total 215 responses were collected. Maximum respondents were from India (90%) followed by Bangladesh (4%). Majority were medical oncologists (41%) followed by cardiologists (23%) & radiation oncologists (20%). Female participation was 18%. Cardiologists encountered cancer diagnosis in 5% of their patients while oncologists encountered average 30% patients with cardiac disease. Risk of cancer therapy related cardiac dysfunction (CTRCD) was estimated < 10% by 39%, 10-20% by 25% and > 20% by 35%. Regarding knowledge of cardio-oncology and familiarity with guidelines, 29% rated themselves poor, 48% average and 23% good. 85% did not have dedicated cardiologist at their centre. Echocardiography was not performed by trained cardiologists at 33% centres. 68% believed in baseline cardiac evaluation for all oncology patients. Cardiology referral was opined for all patients before starting anticancer therapy by 24%, while 10% believed in referral only for cardiac symptoms/toxicity and 66% believed in referral only before starting cardio-toxic therapy. Only 21% were confident of using potentially cardio-toxic treatment in patients with high risk of cardiotoxicity or suboptimal cardiac function. 67% expressed need for separate guidelines for CTRCD in lower-middle-income countries (LMIC) and 70% strongly agreed for separate cardio-oncology clinic to improve patient outcomes. Conclusions: Despite significant growth in field of cardio-oncology in West, there are significant gaps in KAP among health care providers in south-east Asia. Collaboration between cardiologists and oncologists and separate cardio-oncology guidelines will improve KAP of cardio-oncology and consequentially the patient outcomes, for south-east Asian region and LMIC.