Second Opinion Seeking in Paediatric Oncology: Motivations and Predictors.

Introduction: This study investigated the prevalence, methods and factors leading carers of childhood cancer patients to seek second opinions.

Methods: A prospective, questionnaire-based study was conducted among families attending oncology clinics at Sydney Children's Hospital, Randwick. Participants were asked whether they had sought a second opinion for their child and if so, their motivations. Factors including cancer diagnosis, carer demographics and online health seeking behaviours were evaluated in association with second opinions. A separate online questionnaire invited paediatric oncologists worldwide to indicate the frequency of, and their approach to, second opinion requests via email.

Results: Fourteen out of 126 carers (11.1%) sought a second opinion from another oncologist to confirm diagnoses (64.3%), explore treatment options (64.3%) or receive additional information (57.1%). A brain cancer diagnosis was the most significant predictor for second opinion seeking in univariate (p = 0.009) and multivariate analyses (p = 0.015). Among carers who reported using the internet for health information seeking (n = 98), second opinions were independently associated with social media use (p = 0.014) and frequent health-related searches (p = 0.027). Most paediatric oncologists (71/89, 79.8%) had received second opinion requests via email, with 21.3% (19/89) reporting that these occur at least weekly. Surveyed oncologists provided a second opinion for some (59.2%) or all (33.8%) requests they received, with 68.5% supporting guideline development for second opinions in paediatric oncology.

Conclusions: Second opinions are regularly sought by carers of childhood cancer patients, with many paediatric oncologists approached over email. International guidelines may be warranted to assist paediatric oncologists and families in navigating these requests.