ArticleAmerican journal of surgery2020
Refusal of cancer-directed treatment by colon cancer patients: Risk factors and survival outcomes.
Article in American journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictors of treatment refusal in patients with colorectal cancer: A systematic review.Seminars in oncology · 2022Pooled it
- Understanding Surgery Refusal in Patients with Colorectal Liver Metastases.Journal of gastrointestinal cancer · 2026Article
- Demographic Disparities and Factors Influencing Cancer Treatment Decision-Making.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Exploring behavioural motivations of treatment refusal in cancer: a Q-methodological approach.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Risk Model for Predicting Gaps in Surgical Oncology Care Among Patients With Stage I-III Rectal Cancer From KwaZulu-Natal, South Africa.JCO global oncology · 2025Article
- Prehabilitation in Frail Octogenarian and Nonagenarian Patients in Colorectal Cancer Surgery: Short- and Medium-Term Outcomes.Journal of clinical medicine · 2024Article
- Drug-Resistance Biomarkers in Patient-Derived Colorectal Cancer Organoid and Fibroblast Co-Culture System.Current issues in molecular biology · 2024Article
- Declination of Treatment, Racial and Ethnic Disparity, and Overall Survival in US Patients With Breast Cancer.JAMA network open · 2024Article
- Variations in the Type of Adjuvant Chemotherapy Among Stage III Colon Cancer Patients in England.Journal of gastrointestinal cancer · 2023Article
- Reproductive Results in Cancer Survivors after Fertility Sparing Management: The Need for the Standardization of Definitions.Cancers · 2023Review
- Disparities in NCCN Guideline-Compliant Care for Patients with Early-Stage Pancreatic Adenocarcinoma at Minority-Serving versus Non-Minority-Serving Hospitals.Annals of surgical oncology · 2023Article
- Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer.Cancers · 2023Article
- Chemotherapy: how to reduce its adverse effects while maintaining the potency?Medical oncology (Northwood, London, England) · 2023Review
- Article
- Socioeconomic Barriers to CRS HIPEC for Appendiceal Cancer within a Regional Academic Hospital System.Annals of surgical oncology · 2022Article
- Quality of life changes in elderly patients after gastrectomy: perspective of an aged Asian society in the 2010s.Annals of surgical treatment and research · 2022Article
- Quality and Location of the Surgical Episode Mediate a Large Proportion of Socioeconomic-Based Survival Disparities in Patients with Resected Stage I-III Colon Cancer.Annals of surgical oncology · 2022Article
- Disparities in Refusal of Locoregional Treatment for Prostate Adenocarcinoma.JCO oncology practice · 2021Article
- Similarities in Risk for COVID-19 and Cancer Disparities.Clinical cancer research : an official journal of the American Association for Cancer Research · 2021Article
- Factors Associated With Patient's Refusal of Recommended Cancer Surgery: Based on Surveillance, Epidemiology, and End Results.Frontiers in public health · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
aimSurgery with or without chemotherapy represent the only curative option for patients with colon cancer. However, some patients refuse treatment despite the recommendation. This study aims to identify the incidence, risk factors and impact on survival associated with refusal.
methodsA National Cancer Data Base (NCDB) analysis between 1998 and 2012 was performed. We identified 924,290 patients with potentially treatable colon cancer. Patients who underwent treatment were compared with patients that refused.
results7152 patients refused surgery. On multivariable analysis, patients were more likely to refuse if they were older (OR = 1.14; 95% CI 1.14-1.15), female (OR = 1.20; 95% CI 1.12-1.28), African American (vs White, OR = 2.30; 95% CI 2.10-2.51) or on Medicaid (vs private, OR = 3.06; 95% CI 2.49-43.77). Overall survival was worse in patients that refused surgery [median survival 6.8 vs 24 months, Cox hazard ratio (HR) 3.41; 95%CI 3.12-3.60]. Furthermore, 11,334 patients with path. stage III disease refused adjuvant chemotherapy.
conclusionsRefusal of treatment affects survival and is independently associated with several variables (gender, race, insurance status), therefore raising the concern that socioeconomic factors may drive decisions.
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