Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer
(1) Background: Disparities in cancer treatment and outcomes have long been well-documented in the medical literature. With the eruption of advances in new treatment modalities, the long-existing disparities are now being further uncovered and brought to the attention of the medical community. While...
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| Veröffentlicht in: | Cancers 2023-03, Vol.15 (6), p.1686 |
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| creator | Jabbal, Iktej Singh Sabbagh, Saad Itani, Mira Dominguez, Barbara Mohanna, Mohamed Henry, Valencia Liang, Hong Saravia, Diana George, Tiffany Nahleh, Zeina Alley, Evan Arteta-Bulos, Rafael |
| description | (1) Background: Disparities in cancer treatment and outcomes have long been well-documented in the medical literature. With the eruption of advances in new treatment modalities, the long-existing disparities are now being further uncovered and brought to the attention of the medical community. While social health determinants have previously been linked to treatment disparities in lung cancer, we analyzed data from the National Cancer Database to explore sociodemographic and geographic factors related to accepting or declining physician-recommended chemotherapy. Patients diagnosed with metastatic lung cancer between 2004 and 2016 who declined chemotherapy recommended by their physicians were included in this study. Multivariate logistic regression analysis was performed. Cox Regression and Kaplan-Meier analyses were performed to look for survival characteristics. (2) Results: 316,826 patients with Stage IV lung cancer were identified. Factors related to a higher rate of refusal by patients included older age > 70, female sex, low income, lack of insurance coverage, residency in the New England region, and higher comorbidity. Patients living in areas with lower education were less likely to decline chemotherapy. (3) Conclusion: Further understanding of the factors impacting treatment decisions would be essential to improve the efficacy of care delivery in patients with cancer and reduce reversible causes of disparity. |
| doi_str_mv | 10.3390/cancers15061686 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10046757</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A743761261</galeid><sourcerecordid>A743761261</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-bd995cdf4d671274d705594b389c299ec715dfedb14aa7caa1498cb46b3a33cc3</originalsourceid><addsrcrecordid>eNptklFvFCEQx4mxsc3ZZ98MiS--bAsLC8eTuWxtNTnbh-ozYdnZO5pdOIHV9NvLtbW2jZAwE-Y3A__JIPSOkhPGFDm1xluIiTZEULEUr9BRTWRdCaH46yf-ITpO6YaUxRiVQr5Bh0yoJWkkO0JwbmwOMeFVSsE6k6HHv13e4rwFfAbWJRc8zmHvj84DbrcwhRKMZneLncffIJuUTXYWXwZfXU9mHHEL5VjPfoPbuz--RQeDGRMcP9gF-nH--Xv7pVpfXXxtV-vKcs5y1fVKNbYfeC8krSXvJWkaxTu2VLZWCqykTT9A31FujLTGUK6WtuOiY4Yxa9kCfbqvu5u7CXoLPkcz6l10k4m3Ohinn0e82-pN-KUpIVzI0pEF-vhQIYafM6SsJ5dskWM8hDnpWqq6IYpSVdAPL9CbMEdf9O0p2ijFSP2P2pgRtPNDKA_bfVG9kpxJQWtBC3XyH6rsHiZng4fBlftnCaf3CTaGlCIMjyIp0fvp0C-mo2S8f9qbR_7vLLA_M2e2Bg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2791599302</pqid></control><display><type>article</type><title>Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer</title><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Jabbal, Iktej Singh ; Sabbagh, Saad ; Itani, Mira ; Dominguez, Barbara ; Mohanna, Mohamed ; Henry, Valencia ; Liang, Hong ; Saravia, Diana ; George, Tiffany ; Nahleh, Zeina ; Alley, Evan ; Arteta-Bulos, Rafael</creator><creatorcontrib>Jabbal, Iktej Singh ; Sabbagh, Saad ; Itani, Mira ; Dominguez, Barbara ; Mohanna, Mohamed ; Henry, Valencia ; Liang, Hong ; Saravia, Diana ; George, Tiffany ; Nahleh, Zeina ; Alley, Evan ; Arteta-Bulos, Rafael</creatorcontrib><description>(1) Background: Disparities in cancer treatment and outcomes have long been well-documented in the medical literature. With the eruption of advances in new treatment modalities, the long-existing disparities are now being further uncovered and brought to the attention of the medical community. While social health determinants have previously been linked to treatment disparities in lung cancer, we analyzed data from the National Cancer Database to explore sociodemographic and geographic factors related to accepting or declining physician-recommended chemotherapy. Patients diagnosed with metastatic lung cancer between 2004 and 2016 who declined chemotherapy recommended by their physicians were included in this study. Multivariate logistic regression analysis was performed. Cox Regression and Kaplan-Meier analyses were performed to look for survival characteristics. (2) Results: 316,826 patients with Stage IV lung cancer were identified. Factors related to a higher rate of refusal by patients included older age > 70, female sex, low income, lack of insurance coverage, residency in the New England region, and higher comorbidity. Patients living in areas with lower education were less likely to decline chemotherapy. (3) Conclusion: Further understanding of the factors impacting treatment decisions would be essential to improve the efficacy of care delivery in patients with cancer and reduce reversible causes of disparity.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15061686</identifier><identifier>PMID: 36980573</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Cancer ; Cancer therapies ; Care and treatment ; Chemotherapy ; Comorbidity ; Decision making ; Education ; Educational attainment ; Ethnicity ; Geography ; Hispanic Americans ; Histology ; Lung cancer ; Lung cancer, Non-small cell ; Medical prognosis ; Metastases ; Metastasis ; Methods ; Non-small cell lung carcinoma ; Patients ; Race ; Small cell lung carcinoma ; Sociodemographics</subject><ispartof>Cancers, 2023-03, Vol.15 (6), p.1686</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c443t-bd995cdf4d671274d705594b389c299ec715dfedb14aa7caa1498cb46b3a33cc3</cites><orcidid>0000-0003-1703-6811 ; 0000-0001-5203-1050 ; 0000-0001-8991-7445 ; 0000-0001-7618-4545</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046757/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046757/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36980573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jabbal, Iktej Singh</creatorcontrib><creatorcontrib>Sabbagh, Saad</creatorcontrib><creatorcontrib>Itani, Mira</creatorcontrib><creatorcontrib>Dominguez, Barbara</creatorcontrib><creatorcontrib>Mohanna, Mohamed</creatorcontrib><creatorcontrib>Henry, Valencia</creatorcontrib><creatorcontrib>Liang, Hong</creatorcontrib><creatorcontrib>Saravia, Diana</creatorcontrib><creatorcontrib>George, Tiffany</creatorcontrib><creatorcontrib>Nahleh, Zeina</creatorcontrib><creatorcontrib>Alley, Evan</creatorcontrib><creatorcontrib>Arteta-Bulos, Rafael</creatorcontrib><title>Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>(1) Background: Disparities in cancer treatment and outcomes have long been well-documented in the medical literature. With the eruption of advances in new treatment modalities, the long-existing disparities are now being further uncovered and brought to the attention of the medical community. While social health determinants have previously been linked to treatment disparities in lung cancer, we analyzed data from the National Cancer Database to explore sociodemographic and geographic factors related to accepting or declining physician-recommended chemotherapy. Patients diagnosed with metastatic lung cancer between 2004 and 2016 who declined chemotherapy recommended by their physicians were included in this study. Multivariate logistic regression analysis was performed. Cox Regression and Kaplan-Meier analyses were performed to look for survival characteristics. (2) Results: 316,826 patients with Stage IV lung cancer were identified. Factors related to a higher rate of refusal by patients included older age > 70, female sex, low income, lack of insurance coverage, residency in the New England region, and higher comorbidity. Patients living in areas with lower education were less likely to decline chemotherapy. (3) Conclusion: Further understanding of the factors impacting treatment decisions would be essential to improve the efficacy of care delivery in patients with cancer and reduce reversible causes of disparity.</description><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Comorbidity</subject><subject>Decision making</subject><subject>Education</subject><subject>Educational attainment</subject><subject>Ethnicity</subject><subject>Geography</subject><subject>Hispanic Americans</subject><subject>Histology</subject><subject>Lung cancer</subject><subject>Lung cancer, Non-small cell</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Methods</subject><subject>Non-small cell lung carcinoma</subject><subject>Patients</subject><subject>Race</subject><subject>Small cell lung carcinoma</subject><subject>Sociodemographics</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptklFvFCEQx4mxsc3ZZ98MiS--bAsLC8eTuWxtNTnbh-ozYdnZO5pdOIHV9NvLtbW2jZAwE-Y3A__JIPSOkhPGFDm1xluIiTZEULEUr9BRTWRdCaH46yf-ITpO6YaUxRiVQr5Bh0yoJWkkO0JwbmwOMeFVSsE6k6HHv13e4rwFfAbWJRc8zmHvj84DbrcwhRKMZneLncffIJuUTXYWXwZfXU9mHHEL5VjPfoPbuz--RQeDGRMcP9gF-nH--Xv7pVpfXXxtV-vKcs5y1fVKNbYfeC8krSXvJWkaxTu2VLZWCqykTT9A31FujLTGUK6WtuOiY4Yxa9kCfbqvu5u7CXoLPkcz6l10k4m3Ohinn0e82-pN-KUpIVzI0pEF-vhQIYafM6SsJ5dskWM8hDnpWqq6IYpSVdAPL9CbMEdf9O0p2ijFSP2P2pgRtPNDKA_bfVG9kpxJQWtBC3XyH6rsHiZng4fBlftnCaf3CTaGlCIMjyIp0fvp0C-mo2S8f9qbR_7vLLA_M2e2Bg</recordid><startdate>20230309</startdate><enddate>20230309</enddate><creator>Jabbal, Iktej Singh</creator><creator>Sabbagh, Saad</creator><creator>Itani, Mira</creator><creator>Dominguez, Barbara</creator><creator>Mohanna, Mohamed</creator><creator>Henry, Valencia</creator><creator>Liang, Hong</creator><creator>Saravia, Diana</creator><creator>George, Tiffany</creator><creator>Nahleh, Zeina</creator><creator>Alley, Evan</creator><creator>Arteta-Bulos, Rafael</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1703-6811</orcidid><orcidid>https://orcid.org/0000-0001-5203-1050</orcidid><orcidid>https://orcid.org/0000-0001-8991-7445</orcidid><orcidid>https://orcid.org/0000-0001-7618-4545</orcidid></search><sort><creationdate>20230309</creationdate><title>Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer</title><author>Jabbal, Iktej Singh ; Sabbagh, Saad ; Itani, Mira ; Dominguez, Barbara ; Mohanna, Mohamed ; Henry, Valencia ; Liang, Hong ; Saravia, Diana ; George, Tiffany ; Nahleh, Zeina ; Alley, Evan ; Arteta-Bulos, Rafael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-bd995cdf4d671274d705594b389c299ec715dfedb14aa7caa1498cb46b3a33cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Comorbidity</topic><topic>Decision making</topic><topic>Education</topic><topic>Educational attainment</topic><topic>Ethnicity</topic><topic>Geography</topic><topic>Hispanic Americans</topic><topic>Histology</topic><topic>Lung cancer</topic><topic>Lung cancer, Non-small cell</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Methods</topic><topic>Non-small cell lung carcinoma</topic><topic>Patients</topic><topic>Race</topic><topic>Small cell lung carcinoma</topic><topic>Sociodemographics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jabbal, Iktej Singh</creatorcontrib><creatorcontrib>Sabbagh, Saad</creatorcontrib><creatorcontrib>Itani, Mira</creatorcontrib><creatorcontrib>Dominguez, Barbara</creatorcontrib><creatorcontrib>Mohanna, Mohamed</creatorcontrib><creatorcontrib>Henry, Valencia</creatorcontrib><creatorcontrib>Liang, Hong</creatorcontrib><creatorcontrib>Saravia, Diana</creatorcontrib><creatorcontrib>George, Tiffany</creatorcontrib><creatorcontrib>Nahleh, Zeina</creatorcontrib><creatorcontrib>Alley, Evan</creatorcontrib><creatorcontrib>Arteta-Bulos, Rafael</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jabbal, Iktej Singh</au><au>Sabbagh, Saad</au><au>Itani, Mira</au><au>Dominguez, Barbara</au><au>Mohanna, Mohamed</au><au>Henry, Valencia</au><au>Liang, Hong</au><au>Saravia, Diana</au><au>George, Tiffany</au><au>Nahleh, Zeina</au><au>Alley, Evan</au><au>Arteta-Bulos, Rafael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2023-03-09</date><risdate>2023</risdate><volume>15</volume><issue>6</issue><spage>1686</spage><pages>1686-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>(1) Background: Disparities in cancer treatment and outcomes have long been well-documented in the medical literature. With the eruption of advances in new treatment modalities, the long-existing disparities are now being further uncovered and brought to the attention of the medical community. While social health determinants have previously been linked to treatment disparities in lung cancer, we analyzed data from the National Cancer Database to explore sociodemographic and geographic factors related to accepting or declining physician-recommended chemotherapy. Patients diagnosed with metastatic lung cancer between 2004 and 2016 who declined chemotherapy recommended by their physicians were included in this study. Multivariate logistic regression analysis was performed. Cox Regression and Kaplan-Meier analyses were performed to look for survival characteristics. (2) Results: 316,826 patients with Stage IV lung cancer were identified. Factors related to a higher rate of refusal by patients included older age > 70, female sex, low income, lack of insurance coverage, residency in the New England region, and higher comorbidity. Patients living in areas with lower education were less likely to decline chemotherapy. (3) Conclusion: Further understanding of the factors impacting treatment decisions would be essential to improve the efficacy of care delivery in patients with cancer and reduce reversible causes of disparity.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36980573</pmid><doi>10.3390/cancers15061686</doi><orcidid>https://orcid.org/0000-0003-1703-6811</orcidid><orcidid>https://orcid.org/0000-0001-5203-1050</orcidid><orcidid>https://orcid.org/0000-0001-8991-7445</orcidid><orcidid>https://orcid.org/0000-0001-7618-4545</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer Cancer therapies Care and treatment Chemotherapy Comorbidity Decision making Education Educational attainment Ethnicity Geography Hispanic Americans Histology Lung cancer Lung cancer, Non-small cell Medical prognosis Metastases Metastasis Methods Non-small cell lung carcinoma Patients Race Small cell lung carcinoma Sociodemographics |
| title | Factors Associated with the Decision to Decline Chemotherapy in Metastatic Non-Small Cell Lung Cancer |
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