Risk factors associated with treatment refusal in lung cancer

Abstract

BackgroundThe 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.MethodsWe 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.ResultsThe 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.ConclusionIndividual 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.

Treatment, no treatment and early death in Danish stage I lung cancer patients

“…Our findings corroborate those of other studies of surgically treated patients where high alcohol intake was adversely related to outcome 25,26 . Furthermore, our findings regarding alcohol and smoking could also indirectly reflect a lower socioeconomic position among patients not treated 27,28 or even point to a causal status were significant predictors of treatment refusal among 617 lung cancer patients 29 . In our stage -and performance status-restricted study, only 10 patients declined treatment and these patients tended to be older than those who did not receive treatment for other causes, but the burden of comorbidity was not significantly higher than their age, gender and performance status-matched controls.…”

Overexpression of long non‐coding RNA KCNQ1OT1 is related to good prognosis via inhibiting cell proliferation in non‐small cell lung cancer

“…Lung cancer (LC), the most common malignancy in the world, is the first and fourth most deadly malignant disease in men and women, respectively . According to previous studies, LC prognosis is affected by multiple factors, such as the size of the primary tumor, the involvement of regional lymph nodes, and the presence of metastases .…”

Higher Age Puts Lung Cancer Patients at Risk for Not Receiving Anti-cancer Treatment

“…However, in this study, staging of the treated and the non-treated group was not available. Our study needs to validate considering staging of all lung cancer patients, while retrospective study failed to demonstrate significant association between lung cancer treatment refusal and staging in Korea [16].…”