ArticleBMC palliative care2023
How do cancer patients refuse treatment? A grounded theory study.
Article in BMC palliative care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Why Do Cancer Patients Decide to Withdraw Their Treatment? A Systematic Review and Meta-Synthesis.Cancer medicine · 2026Pooled it
- Refusal of Hospital-Based Oral Cancer Treatment Driven by Health Beliefs in Pakistan: A Qualitative Study.International dental journal · 2026Article
- Article
- Cultural foundations of university student well-being: a grounded theory study of a multidimensional framework in Indonesia.BMC psychology · 2026Article
- Exploring Factors Influencing Decisions to Withdraw Treatment in Iranian Patients With Metastatic Cancer: A Qualitative Content Analysis Study.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2026Article
- Characteristics, Prognosis and Reasons for Opting-Out of Treatment in Patients with Untreated Pancreatic Cancer.Current oncology (Toronto, Ont.) · 2026Article
- Pain and Suicide Behavior in Cancer Patients: Implications for Personalized Treatment-A Systematic Review.Journal of personalized medicine · 2026Review
- Comprehensive assessment of privacy security of financial services in cloud environment.Scientific reports · 2025Article
- Demographic Disparities and Factors Influencing Cancer Treatment Decision-Making.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Burden of prolonged treatment delay among patients with common cancers in the Philippines.Cancer causes & control : CCC · 2025Article
- "Current", "heated rods", and "hot vapour": why patients refuse radiotherapy as a treatment modality for cancer in northern Sri Lanka.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Declination of Treatment, Racial and Ethnic Disparity, and Overall Survival in US Patients With Breast Cancer.JAMA network open · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAll cancer patients, except for a small fraction, seek treatment after becoming aware of the disease. That small fraction do not seek any treatment due to various reasons, and this phenomenon is unknown to us. Therefore, the present study aimed to discover the reasons for treatment refusal in cancer patients.
methodsThis qualitative grounded theory study was conducted on 22 participants including patients, caregivers, physicians, and nurses. Purposive theoretical sampling was employed. Data were collected through in-depth interviews. All interviews were gradually transcribed and analyzed. Data analysis was carried out through the three-step method of open, axial, and selective coding and was continued until theoretical saturation. Straussian Grounded Theory was used for data analysis.
resultsA total of 4 themes and 20 sub-themes were extracted in this study. The core variable extracted from the interviews was "resilience" Other related themes included encounter with cancer, fighting cancer, and coping with cancer. The findings showed that in the context of fighting cancer, patients lost their resilience through various processes and refused treatment.
conclusionCancer patients abandon the treatment in silence, oncologists and even family members being unaware of the matter. In other words, refusal of treatment is like an iceberg and the majority of the patients who have abandoned treatment are unknown to the health system. The model obtained in this study can increase the knowledge of the process that leads patients to lose their resilience against cancer and abandon treatment, which can increase the possibility of recognizing and predicting treatment refusal for oncologists.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.