ORIGINAL ARTICLE Referral practices of pediatric oncologists to specialized palliative care Kirsten Wentlandt & Monika K. Krzyzanowska & Nadia Swami & Gary Rodin & Lisa W. Le & Lillian Sung & Camilla Zimmermann Received: 3 December 2013 /Accepted: 4 March 2014 /Published online: 27 March 2014 # Springer-Verlag Berlin Heidelberg 2014 Abstract Purpose The aims of this study are to describe the attitudes and referral practices of pediatric oncologists (POs) to spe- cialized palliative care (SPC), and to compare them with those of adult oncologists (AOs). Methods Canadian members of the American Society of Pediatric Hematology/Oncology (ASPHO), Canadian Association of Medical Oncologists (CAMO), Canadian Association of Radiation Oncologists (CARO), and the Canadian Society of Surgical Oncology (CSSO) participated in an anonymous survey assessing SPC referral practices. Results The response rate was 70 % (646/921), 52 % (43/82) for ASPHO members; 5 CARO members self-identified as POs, for a total of 48 POs and 595 AOs. Ninety-six percent of POs had access to inpatient SPC consultation services (vs. 48 % AOs), 31 % to a PCU (vs. 82 % AOs), and 27 % to an outpatient SPC clinic (vs. 73 % AOs). POs more often stated their SPC services accepted patients on chemotherapy than AOs (64 vs. 37 %, p =0.0004). POs were less likely to refer only after chemotherapy had been stopped (13 vs. 29 % for AOs) and more likely to state that ideally referral should occur at the diagnosis of cancer/incurable cancer (73 vs. 43 %). POs were more likely to agree they would refer earlier if palliative care were renamed “ supportive care ” (58 vs. 33 %, p < 0.0001), that palliative care adds too many providers (17 vs. 7 %, p =0.002), and that palliative care was perceived negatively by their patients (60 vs. 43 %, p =0.02). Conclusions Although POs acknowledge the importance of early referral to SPC for children with cancer, there remain resource and attitudinal barriers to overcome in this regard. K. Wentlandt Department of Family and Community Medicine, University of Toronto, Toronto, Canada M. K. Krzyzanowska : C. Zimmermann Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada G. Rodin Department of Psychiatry, University of Toronto, Toronto, Canada K. Wentlandt : N. Swami : G. Rodin : C. Zimmermann Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada G. Rodin : C. Zimmermann Campbell Family Cancer Research Center, Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada M. K. Krzyzanowska Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada L. W. Le Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada L. Sung Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada K. Wentlandt (*) Toronto General Hospital, University Health Network, 9NU-925, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada e-mail: Kirsten.Wentlandt@uhn.ca Support Care Cancer (2014) 22:2315–2322 DOI 10.1007/s00520-014-2203-6