Clinical and Social Determinants of Treatment Adherence in Cancer Patients: The Contributory Role of Hearing Loss

Treatment adherence is a key determinant of outcomes in cancer patients and is influenced by multiple clinical and social factors. Hearing loss (HL) may contribute to communication barriers and treatment disruption. This study aimed to evaluate the relationship between HL and treatment adherence.

In this single-center prospective observational study, 79 newly diagnosed cancer patients undergoing systemic therapy were evaluated with baseline pure-tone audiometry. HL was categorized by severity. Treatment adherence was assessed based on missed cycles and treatment continuity. Clinical variables, including treatment-related adverse events and caregiver presence, were analyzed using chi-square tests and logistic regression analyses.

HL was present in 67.1% of patients. Overall, 55.7% missed at least one treatment cycle. Missed cycles were more frequent in patients with HL (p = 0.016), and higher HL severity was associated with increased treatment disruption (p = 0.015). In univariate analysis, HL, older age, absence of a caregiver, and treatment-related adverse events were associated with nonadherence. In multivariate analysis, only treatment-related adverse events remained independently significant (OR = 93.2; p < 0.001).

Treatment adherence appears to be primarily driven by clinical factors, particularly treatment-related toxicity. HL was associated with treatment disruption but was not an independent predictor and may act as a contributing factor.

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