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Who does not receive treatment for cancer?
Marcia M Ward1, Fred Ullrich, Kevin Matthews
1University of Iowa, Iowa City, IA, USA. marcia-m-ward@uiowa.edu
Journal of Oncology Practice
|May 2, 2013
Summary
Cancer nontreatment affects 12.3% of patients, a rate higher than previously reported. Nontreatment is linked to specific cancer types, advanced stages, older age, and non-accredited facilities.
Area of Science:
- Oncology
- Cancer Care Delivery Research
- Public Health
Background:
- Limited data exists on cancer nontreatment rates.
- National Cancer Data Base (NCDB) suggests 9.2% of patients receive no first course of treatment.
- NCDB data is limited to accredited cancer programs, potentially underestimating nontreatment rates.
Purpose of the Study:
- To determine the rate and characteristics of patients with cancer who do not receive a first course of treatment.
- To utilize a population-representative data source for a more accurate assessment.
- To compare nontreatment rates with existing NCDB data.
Main Methods:
- Utilized the Iowa Cancer Registry (ICR) data from 2004-2010.
- ICR captures all newly diagnosed cancer cases in Iowa residents.
- Employed logistic regression to identify factors associated with nontreatment.
Main Results:
- 12.3% of newly diagnosed cancer patients in the ICR did not receive a first course of treatment.
- This rate is 48% higher than the NCDB rate for Iowa (8.3%).
- Nontreatment was associated with specific cancers (lung, lymphoma), advanced stage, older patients, non-accredited facilities, and lack of specialist consultation.
Conclusions:
- Cancer nontreatment rates vary by cancer type, stage, and facility accreditation.
- Nontreatment is higher in non-accredited cancer programs compared to accredited ones.
- Patient and provider/facility characteristics influence nontreatment decisions.
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