Abstract
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.
Footnotes
Authors' Contributions
All Authors contributed to the study design, commented on previous versions of the manuscript, read and approved the final manuscript. Material preparation, data collection and analysis were performed by DJR, ACS and AJF. The first draft of the manuscript was written by DJR and DB.
Funding
This study was supported, in part, by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Received July 10, 2019.
- Revision received July 29, 2019.
- Accepted July 30, 2019.
- Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved