Rationale: Surgery remains the primary treatment for many solid tumours. Over the past few decades, however, neoadjuvant therapies have increasingly been shown to enhance outcomes. Multidisciplinary assessment prior to surgery in the form of tumour conferences improves adherence to evidence-based guidelines and improves outcomes. The British Columbia Cancer Agency (BCCA) and the Vancouver General Hospital, BC’s largest teaching hospital, conducted a retrospective study to examine 2 questions: To what extent are surgical oncology patients referred for multidisciplinary assessment? If done, does this assessment occur before or after surgery? Methods: All surgical cases flagged as oncology cases at the Vancouver General and University of British Columbia (UBC) hospitals for a 3-month period were linked to the BC Cancer Registry and the BC Cancer Information System. The percentage of cases referred to the BCCA was calculated. The data were stratified by surgical specialty and then by whether the patient was seen at the BCCA before or after surgery. An analysis was also done of referral rates by surgical specialties with well-defined provincial programs vs those without such programs. Results: Overall, 64.9% of cases were referred to the formal cancer system, i.e. the BCCA, in connection to their surgical episode. Of these, 66.4% were seen in advance of their surgery and 33.6% were seen afterwards. A further 11.3% of patients were seen at the BCCA but the time of their visit could not reasonably have been associated with the episode of care involving the relevant surgery. A statistically significant difference was found in favour of specialties with well-defined provincial programs compared to other surgical specialties. Conclusion: Defined provincial programs are associated with higher referral to the formal cancer treatment system.