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. 2020 Jan;42(1):33-42.
doi: 10.1002/hed.25966. Epub 2019 Oct 4.

Factors predicting for patient refusal of head and neck cancer therapy

Arya Amini  1 , Vivek Verma  2 , Richard Li  1 , Nayana Vora  1 , Robert Kang  3 , Thomas J Gernon  3 , Sue Chang  4 , Sana Karam  5 , Erminia Massarelli  6 , Ellie G Maghami  3 , Scott Glaser  1
Affiliations

Factors predicting for patient refusal of head and neck cancer therapy

Arya Amini et al. Head Neck. 2020 Jan.

Abstract

Background: The purpose of this study was to evaluate the national rate of treatment refusal in head and neck cancer (HNC).

Methods: The National Cancer Database was queried for nonmetastatic squamous cell carcinoma of the head and neck. Oncologic therapy referred to receipt of surgery, radiotherapy, or chemotherapy.

Results: Compared to the 230 424 patients who received treatment, 2965 (1.3%) were reported to have refused definitive therapy. Predictors included older age, female sex, African-American/other race, nonprivate insurance, greater comorbidities, more advanced disease, and residence closer to the treating facility (P < .05). Patients with a prior history of cancer, Hispanic race, those treated at academic centers, and those from higher income counties were less likely to refuse therapy (P < .05). Patients who refused definitive therapy experienced poorer survival (median 79.1 vs 8.7 months, P < .001).

Conclusions: Refusing oncologic therapy is relatively rare in HNC and appears to be multifocal in nature.

Keywords: definitive treatment; head and neck cancer; radiation; radiotherapy; socioeconomic factors; surgery; treatment refusal.

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References

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