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Objective: Trust is a vital component of the patient-provider relationship. Higher trust is associated with increased adherence to treatment and improved outcomes. The purpose of this study was to compare colorectal cancer (CRC) survivors' reported trust toward their primary care physician (PCP) and oncologist (ONC).

Methods: CRC survivors (n=62) were surveyed using the Trust in Oncologist (TiOS) instrument that assessed five domains (honesty, fidelity, caring, competence, and global/overall) using a 5-point Likert scale. Social and demographic variables were analyzed using nonparametric tests.

Results: Mean trust was higher toward the ONC compared to the PCP across all TiOS domains (P=0.001-0.023). Trust was lowest in the competence and caring domains for both ONC and PCP. Younger age was associated with lower trust compared to older age (P=.0002, P=0.018). Higher cancer stage was associated with significantly lower trust toward PCP (P=0.074).

Conclusion: Results confirm the importance of trust between cancer patients and physicians. Although CRC survivors report high overall trust toward their oncologist, they do not always believe their oncologist is competent to treat their disease. We propose the novel concept of Forced Attachment Theory to explain the phenomenon of an obligated sense of attachment from CRC patients toward their treating physicians.


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