Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer

Autor: Iktej Singh Jabbal, Saad Sabbagh, Mira Itani, Barbara Dominguez, Mohamed Mohanna, Valencia Henry, Hong Liang, Diana Saravia, Tiffany George, Zeina Nahleh, Evan Alley, Rafael Arteta-Bulos
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cancers; Volume 15; Issue 6; Pages: 1686
ISSN: 2072-6694
DOI: 10.3390/cancers15061686
Popis: (1) Background: Disparities in cancer treatment and outcomes have long been well-documented in the medical literature. With the eruption of advances in new treatment modalities, the long-existing disparities are now being further uncovered and brought to the attention of the medical community. While social health determinants have previously been linked to treatment disparities in lung cancer, we analyzed data from the National Cancer Database to explore sociodemographic and geographic factors related to accepting or declining physician-recommended chemotherapy. Patients diagnosed with metastatic lung cancer between 2004 and 2016 who declined chemotherapy recommended by their physicians were included in this study. Multivariate logistic regression analysis was performed. Cox Regression and Kaplan-Meier analyses were performed to look for survival characteristics. (2) Results: 316,826 patients with Stage IV lung cancer were identified. Factors related to a higher rate of refusal by patients included older age > 70, female sex, low income, lack of insurance coverage, residency in the New England region, and higher comorbidity. Patients living in areas with lower education were less likely to decline chemotherapy. (3) Conclusion: Further understanding of the factors impacting treatment decisions would be essential to improve the efficacy of care delivery in patients with cancer and reduce reversible causes of disparity.
Databáze: OpenAIRE
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