ArticleSurgery open science2020
Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort.
Article in Surgery open science, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 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
- A virulent bacterial signature is associated with the development of recurrence following colorectal cancer surgery.Nature communications · 2026Article
- Understanding Surgery Refusal in Patients with Colorectal Liver Metastases.Journal of gastrointestinal cancer · 2026Article
- Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors.Cancer medicine · 2025Article
- The Rise of Patients Declining Rectal Cancer Surgery in the Era of Total Neoadjuvant Therapy.Annals of surgical oncology · 2024Article
- Declination of Treatment, Racial and Ethnic Disparity, and Overall Survival in US Patients With Breast Cancer.JAMA network open · 2024Article
- A population-based propensity score matching analysis of risk factors and the impact on survival associated with refusal of cancer-directed surgery in patients with prostate cancer.Scientific reports · 2024Article
- Navigating Choices: Determinants and Outcomes of Surgery Refusal in Thyroid Cancer Patients Using SEER Data.Cancers · 2023Article
- A Machine Learning-Based Investigation of Gender-Specific Prognosis of Lung Cancers.Medicina (Kaunas, Lithuania) · 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
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study aims to understand patient factors associated with refusal of surgery for nonmetastatic colorectal cancer and the associated cancer-specific mortality.
methodsPatients diagnosed with nonmetastatic colorectal cancer between 2004 and 2015 from the Surveillance, Epidemiology, and End Results Program were included.
resultsA total of 152,731 (99.4%) patients underwent surgery, and 983 (0.6%) refused surgery. Independent predictors of refusal included male sex, older age, minority race, single relationship status, being uninsured, more recent date of diagnosis, having an earlier stage of diagnosis, and rectal versus colon cancer. Refusing surgery for nonmetastatic colorectal cancer increased cancer-specific mortality (adjusted hazard ratio 5.10, 95% confidence interval 4.62-5.62).
conclusionMost patients diagnosed with nonmetastatic colorectal cancer undergo surgery in the United States. However, refusal of surgery is increasing and associated with higher cancer-specific mortality. A better understanding of surgical decision making in colorectal cancer is urgently needed.
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Registered trials
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