Anticancer Research · 2019 · 27 citations · 11 references
MedicineOncologySurgeryBreast OncologyCancer EpidemiologySurgical OncologyBreast Cancer SurgeryBreast SurgeryCancer DisparitiesCancer Health DisparitiesWithholding TreatmentGovernment Backed InsurancePrivate Insurance CoverageRacial Cancer DisparitiesRacial Risk DisparitiesRefusal Of SurgeryTreatment Of Uninsured PatientsTreatment Refusal ManagementUninsured Rates
AIM: This study describes the demographic, socioeconomic, and tumor-specific characteristics of patients who refuse breast cancer surgery. MATERIALS AND METHODS: This is a retrospective study of breast cancer patients from 2004-2015 captured by the National Cancer Data Base. Demographic, socioeconomic, and tumor-specific predictors were compared between patients who refused breast cancer surgery versus those who agreed to surgery, using bivariate and multivariate models. RESULTS: A total of 2,445,870 patients met the inclusion criteria. On multivariate analysis, black and Asian patients had higher odds of refusing surgical treatment compared to whites (OR=2.16, CI=2.05-2.28, p<0.001), (OR=1.58, CI=1.41-1.76, p<0.001), respectively. Moreover, patients with government insurance (OR=1.97, CI=1.86-2.09, p<0.001) and uninsured patients (OR=3.91, CI=3.50-4.36, p<0.001) were found to have higher odds of surgical treatment refusal when compared to patients with private insurance. CONCLUSION: Specific demographic and disease-specific characteristics are related to refusing potentially life-saving breast cancer surgery.
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Rebecca L. Siegel, Kimberly D. Miller, Ahmedin Jemal · CA A Cancer Journal for Clinicians · 2019 · 21K citations · Full text