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Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort

INTRODUCTION: This study aims to understand patient factors associated with refusal of surgery for nonmetastatic colorectal cancer and the associated cancer-specific mortality. METHODS: Patients diagnosed with nonmetastatic colorectal cancer between 2004 and 2015 from the Surveillance, Epidemiology,...

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Autores principales: Delisle, Megan, Singh, Shubhi, Howard, Jeffrey, Panda, Nikhil, Weppler, Alison M, Wang, Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451747/
https://www.ncbi.nlm.nih.gov/pubmed/32885158
http://dx.doi.org/10.1016/j.sopen.2020.07.001
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author Delisle, Megan
Singh, Shubhi
Howard, Jeffrey
Panda, Nikhil
Weppler, Alison M
Wang, Ying
author_facet Delisle, Megan
Singh, Shubhi
Howard, Jeffrey
Panda, Nikhil
Weppler, Alison M
Wang, Ying
author_sort Delisle, Megan
collection PubMed
description INTRODUCTION: This study aims to understand patient factors associated with refusal of surgery for nonmetastatic colorectal cancer and the associated cancer-specific mortality. METHODS: Patients diagnosed with nonmetastatic colorectal cancer between 2004 and 2015 from the Surveillance, Epidemiology, and End Results Program were included. RESULTS: A total of 152,731 (99.4%) patients underwent surgery, and 983 (0.6%) refused surgery. Independent predictors of refusal included male sex, older age, minority race, single relationship status, being uninsured, more recent date of diagnosis, having an earlier stage of diagnosis, and rectal versus colon cancer. Refusing surgery for nonmetastatic colorectal cancer increased cancer-specific mortality (adjusted hazard ratio 5.10, 95% confidence interval 4.62–5.62). CONCLUSION: Most patients diagnosed with nonmetastatic colorectal cancer undergo surgery in the United States. However, refusal of surgery is increasing and associated with higher cancer-specific mortality. A better understanding of surgical decision making in colorectal cancer is urgently needed.
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spelling pubmed-74517472020-09-02 Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort Delisle, Megan Singh, Shubhi Howard, Jeffrey Panda, Nikhil Weppler, Alison M Wang, Ying Surg Open Sci Article INTRODUCTION: This study aims to understand patient factors associated with refusal of surgery for nonmetastatic colorectal cancer and the associated cancer-specific mortality. METHODS: Patients diagnosed with nonmetastatic colorectal cancer between 2004 and 2015 from the Surveillance, Epidemiology, and End Results Program were included. RESULTS: A total of 152,731 (99.4%) patients underwent surgery, and 983 (0.6%) refused surgery. Independent predictors of refusal included male sex, older age, minority race, single relationship status, being uninsured, more recent date of diagnosis, having an earlier stage of diagnosis, and rectal versus colon cancer. Refusing surgery for nonmetastatic colorectal cancer increased cancer-specific mortality (adjusted hazard ratio 5.10, 95% confidence interval 4.62–5.62). CONCLUSION: Most patients diagnosed with nonmetastatic colorectal cancer undergo surgery in the United States. However, refusal of surgery is increasing and associated with higher cancer-specific mortality. A better understanding of surgical decision making in colorectal cancer is urgently needed. Elsevier 2020-07-19 /pmc/articles/PMC7451747/ /pubmed/32885158 http://dx.doi.org/10.1016/j.sopen.2020.07.001 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Delisle, Megan
Singh, Shubhi
Howard, Jeffrey
Panda, Nikhil
Weppler, Alison M
Wang, Ying
Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
title Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
title_full Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
title_fullStr Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
title_full_unstemmed Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
title_short Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
title_sort refusal of colorectal cancer surgery in the united states: predictors and associated cancer-specific mortality in a surveillance, epidemiology, and end results (seer) cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451747/
https://www.ncbi.nlm.nih.gov/pubmed/32885158
http://dx.doi.org/10.1016/j.sopen.2020.07.001
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