Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.

<h4>Background</h4>Lung cancer is the leading cause mortality among all cancers in Taiwan. Although Taiwan offers National Health Insurance (NHI), occasionally, patients refuse treatment. This study examined the patient characteristics and factors associated with lung cancer patients ref...

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Autores principales:	Hsiu-Ling Huang, Pei-Tseng Kung, Chang-Fang Chiu, Yueh-Hsin Wang, Wen-Chen Tsai
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ff08631eaafa450996e639e6287ab97b
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spelling	oai:doaj.org-article:ff08631eaafa450996e639e6287ab97b2021-11-25T06:09:36ZFactors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.1932-620310.1371/journal.pone.0101731https://doaj.org/article/ff08631eaafa450996e639e6287ab97b2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24999633/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Lung cancer is the leading cause mortality among all cancers in Taiwan. Although Taiwan offers National Health Insurance (NHI), occasionally, patients refuse treatment. This study examined the patient characteristics and factors associated with lung cancer patients refusing cancer treatment in four months after cancer diagnosed and compared the survival differences between treated and non-treated patients.<h4>Methods</h4>The study included 38584 newly diagnosed lung cancer patients between 2004 and 2008, collected from the Taiwan Cancer Registry, which was linked with NHI research database and Cause of Death data set. Logistic regression was conducted to analyze factors associated with treatment refusal. The Cox proportional hazards model was used to examine the effects of treatment and non-treatment on patient survival and the factors affecting non-treatment patient survival.<h4>Results</h4>Among the newly diagnosed cancer patients, older adults, or those who had been diagnosed with other catastrophic illnesses, an increased pre-cancer Charlson Comorbidity Index (CCI) score, and advanced stage cancer exhibited an increased likelihood of refusing treatment. Compared with treated patients, non-treated patients showed an increased mortality risk of 2.09 folds. The 1-year survival rate of treated patients (53.32%) was greater than that of non-treated patients (21.44%). Among the non-treated patients, those who were older, resided in lowly urbanized areas, had other catastrophic illnesses, a CCI score of ≥4, advanced cancer, or had received a diagnosis from a private hospital exhibited an increased mortality risk.<h4>Conclusions</h4>Despite Taiwan's NHI system, some lung cancer patients choose not to receive cancer treatment and the mortality rate for non-treated patients is significantly higher than that of patients who undergo treatment. Therefore, to increase the survival rate of cancer patients, treatment refusal should be addressed.Hsiu-Ling HuangPei-Tseng KungChang-Fang ChiuYueh-Hsin WangWen-Chen TsaiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e101731 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hsiu-Ling Huang Pei-Tseng Kung Chang-Fang Chiu Yueh-Hsin Wang Wen-Chen Tsai Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.
description	<h4>Background</h4>Lung cancer is the leading cause mortality among all cancers in Taiwan. Although Taiwan offers National Health Insurance (NHI), occasionally, patients refuse treatment. This study examined the patient characteristics and factors associated with lung cancer patients refusing cancer treatment in four months after cancer diagnosed and compared the survival differences between treated and non-treated patients.<h4>Methods</h4>The study included 38584 newly diagnosed lung cancer patients between 2004 and 2008, collected from the Taiwan Cancer Registry, which was linked with NHI research database and Cause of Death data set. Logistic regression was conducted to analyze factors associated with treatment refusal. The Cox proportional hazards model was used to examine the effects of treatment and non-treatment on patient survival and the factors affecting non-treatment patient survival.<h4>Results</h4>Among the newly diagnosed cancer patients, older adults, or those who had been diagnosed with other catastrophic illnesses, an increased pre-cancer Charlson Comorbidity Index (CCI) score, and advanced stage cancer exhibited an increased likelihood of refusing treatment. Compared with treated patients, non-treated patients showed an increased mortality risk of 2.09 folds. The 1-year survival rate of treated patients (53.32%) was greater than that of non-treated patients (21.44%). Among the non-treated patients, those who were older, resided in lowly urbanized areas, had other catastrophic illnesses, a CCI score of ≥4, advanced cancer, or had received a diagnosis from a private hospital exhibited an increased mortality risk.<h4>Conclusions</h4>Despite Taiwan's NHI system, some lung cancer patients choose not to receive cancer treatment and the mortality rate for non-treated patients is significantly higher than that of patients who undergo treatment. Therefore, to increase the survival rate of cancer patients, treatment refusal should be addressed.
format	article
author	Hsiu-Ling Huang Pei-Tseng Kung Chang-Fang Chiu Yueh-Hsin Wang Wen-Chen Tsai
author_facet	Hsiu-Ling Huang Pei-Tseng Kung Chang-Fang Chiu Yueh-Hsin Wang Wen-Chen Tsai
author_sort	Hsiu-Ling Huang
title	Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.
title_short	Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.
title_full	Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.
title_fullStr	Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.
title_full_unstemmed	Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.
title_sort	factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in taiwan.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/ff08631eaafa450996e639e6287ab97b
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Factors associated with lung cancer patients refusing treatment and their survival: a national cohort study under a universal health insurance in Taiwan.

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