Risk factors associated with treatment refusal in lung cancer

Won Na Suh, Kyoung Ae Kong, Yeji Han, Soo Jung Kim, Su Hwan Lee, Yon Ju Ryu, Jin Hwa Lee, Sung Shine Shim, Yookyung Kim, Jung Hyun Chang

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background: The incidence of lung cancer is increasing with longer life expectancy. Refusal of active treatment for cancer is prone to cause patients to experience more severe symptoms and shorten survival. The purpose of this study was to define the factors related to refusal or abandonment of active therapy in lung cancer. Methods: We retrospectively reviewed the data of 617 patients from medical records from 2010 to 2014. Two groups were formed: 149 patients who refused anti-cancer treatment and allowed only palliative care were classified into the non-treatment group, while the remaining 468 who received anti-cancer treatment were classified into the treatment group. Results: The groups differed significantly in age, employment, relationship status, number of offspring, educational status, body mass index, presence of chest and systemic symptoms, Charlson Comorbidity Index, Eastern Cooperative Oncology Group score, and tumor node metastasis stage (P < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07–1.13), educational status lower than high school (OR 1.95, 95% CI 1.2–3.2), no history of surgery (OR 2.29, 95% CI 1.4–3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3–4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3–10.8) were significant factors for refusal of cancer treatment. Conclusion: Individual factors, such as old age, low educational status, low weight, and poor performance status can influence refusal of cancer treatment in patients with lung cancer, and should be considered prior to consultation with patients.

Original languageEnglish
Pages (from-to)443-450
Number of pages8
JournalThoracic Cancer
Volume8
Issue number5
DOIs
StatePublished - Sep 2017

Keywords

  • Age
  • comorbidity
  • lung cancer
  • treatment refusal

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