Factors Associated with Refusal or Discontinuation of Treatment in Patients with Bladder Cancer: A Cohort Population-Based Study in Taiwan

Nai-Tan Chang, Ying-Hsu Chang, Yu-Tung Huang and Shu-Ching Chen
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Nai-Tan Chang: Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
Ying-Hsu Chang: Department of Urology, New Taipei Municipal Tucheng Hospital Chang Gung Memorial Hospital, New Taipei 236, Taiwan
Yu-Tung Huang: Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
Shu-Ching Chen: School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

IJERPH, 2021, vol. 18, issue 2, 1-10

Abstract: Cancer treatment causes adverse effects that lead to refusal or discontinuation of treatment. The purposes of this study were to identify 1) the factors associated with and 2) the reasons for refusing and discontinuing treatment in patients with bladder cancer (BC). We conducted a retrospective cohort study in patients diagnosed with BC in Taiwan from 1 January 2014 to 30 June 2019 using a linked cancer registry database. Of the 1247 BC patients in the study cohort, 2.1% reported refusing treatment. Patients with less education and those diagnosed at cancer stage II–IV were more likely to refuse treatment. The major reason for refusing treatment was “patient or the family considered patient’s poor physical condition (chronic disease or unstable systemic disease), difficulty in enduring any condition likely to cause physical discomfort from disease treatment”. A total of 4.3% of BC patients reported discontinuing treatment. Patients not living in the northern region of Taiwan and those diagnosed at cancer stage II–IV were more likely to terminate treatment before completion. The major reason given for discontinuing treatment was inconvenient transportation. Sufficient social resources and supportive care can help BC patients cope with the physical and psychological burden of treatment.

Keywords: bladder cancer; refusing treatment; discontinuing treatment; patient non-compliance; case management (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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