ArticleBMC cancer2014
Characteristics, survival, and related factors of newly diagnosed colorectal cancer patients refusing cancer treatments under a universal health insurance program.
Article in BMC cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Predictors of treatment refusal in patients with colorectal cancer: A systematic review.Seminars in oncology · 2022Pooled it
- Cancer diagnostic tools to aid decision-making in primary care: mixed-methods systematic reviews and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2020Pooled it
- Effect of Chemotherapy Treatment on Overall Survival of Colon Cancer Patients Using Propensity Score Matching.Cureus · 2025Article
- Declination of Treatment, Racial and Ethnic Disparity, and Overall Survival in US Patients With Breast Cancer.JAMA network open · 2024Article
- Refusal of treatment among HER2-positive breast cancer patients in China: a retrospective analysis.Frontiers in public health · 2023Article
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- Assessing how routes to diagnosis vary by the age of patients with cancer: a nationwide register-based cohort study in Denmark.BMC cancer · 2022Article
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- Fatalism, distrust, and breast cancer treatment refusal in Ghana.Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2022Article
- Factors associated with the refusal of surgery and the associated impact on survival in patients with rectal cancer using the National Cancer Database.Journal of gastrointestinal oncology · 2021Article
- Propensity Score Matching Analysis of the Effect of Payer Status on the Survival of Colon Cancer Patients.Cureus · 2021Article
- Survival of colorectal cancer patients in Brunei Darussalam: comparison between 2002-09 and 2010-17.BMC cancer · 2021Article
- Metastasis Patterns and Prognosis of Elderly Patients With Esophageal Adenocarcinoma in Stage IVB: A Population-Based Study.Frontiers in oncology · 2021Article
- Factors impacting on discordance with treatment plan in head and neck cancer patients: a retrospective, population-based cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Survival Analysis of Antineoplastic Treatment for Older Patients with Metastatic Non-Small-Cell Lung Cancer: A Clinical Database Study.Cancer management and research · 2020Article
- The Stage IV Shuffle: Elusiveness of Straight Talk About Advanced Cancer.Journal of general internal medicine · 2019Article
- Article
- Effect of length of time from diagnosis to treatment on colorectal cancer survival: A population-based study.PloS one · 2019Article
- Article
- Influence of the time interval from diagnosis to treatment on survival for early-stage liver cancer.PloS one · 2018Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundColorectal cancer is the third most commonly diagnosed cancer worldwide. Few studies have addressed the causes and risks of treatment refusal in a universal health insurance setting.
methodsWe examined the characteristics and survival associated with treatment refusal in patients with newly diagnosed colorectal cancer in Taiwan during 2004-2008. Treatment refusal was defined as not undergoing any cancer treatment within 4 months of confirmed cancer diagnosis. Patient data were extracted from four national databases. Factors associated with treatment refusal were identified through logistic regression using the generalized estimating equation method, and survival analysis was performed using the Cox proportional hazards model.
resultsOf the 41,340 new colorectal cancer cases diagnosed, 3,612 patients (8.74%) refused treatment. Treatment refusal rate was higher in patients with less urbanized areas of residence, lower incomes, preexisting catastrophic illnesses, cancer stages of 0 and IV, and diagnoses at regional and district hospitals. Logistic regression analysis revealed that patients aged >75 years were the most likely to refuse treatment (OR, 1.87); patients with catastrophic illnesses (OR, 1.66) and stage IV cancer (OR, 1.43) had significantly higher refusal rates. The treatment refusers had 2.66 times the risk of death of those who received treatment. Factors associated with an increased risk of death in refusers included age ≥ 75 years, insured monthly salary ≥ 22,801 NTD, low-income household or aboriginal status, and advanced cancer stage (especially stage IV; HR, 11.33).
conclusionOur results show a lower 5-year survival for colorectal patients who refused treatment than for those who underwent treatment within 4 months. An age of 75 years or older, low-income household status, advanced stages of cancer, especially stage IV, were associated with higher risks of death for those who refused treatment.
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