Causes of Treatment Abandonment of Pediatric Cancer Patients– Experience in a Regional Cancer Centre in North East India

Abstract

Introduction: Refusal and abandonment of treatment is often considered as an important reason for poor survival of<br />pediatric cancer patients in developing and underdeveloped countries. In this study we analyze the factors responsible<br />for treatment abandonment and refusal in a Regional Cancer Centre (RCC) in North East India. Material and Methods:<br />All histopathologically or cytologically confirmed cases of childhood cancer from below 15 years of age registered from<br />1st April, 2010 to 31st March, 2017 were included in this study. Parents or caregivers were interviewed thoroughly and<br />a questionnaire was filled up for analysis of demographic and socio-economic factors. Modified Kuppuswamy scale<br />was used to measure socioeconomic status. Results: Of 592 patients 161 (27.1%) abandoned therapy and 23 (3.9%)<br />refused treatment. Factors associated with abandonment of treatment included: lower risk if residing in urban areas<br />(Odds ratio [OR] = 0.8333, 95% CI 0.565-1.228; P=0.36) and higher risk with maternal education less than secondary<br />school (OR = 1.357; 95%CI: 0.553-3.326; P=0.505). Low socioeconomic status and age >5yrs were also associated<br />with abandonment of treatment. In a binary logistic regression analysis, male sex [Odds Ratio (OR) = 0.701; 95% CI<br />0.48-1.01; P=0.062] have lowest risk of abandoning treatment with trend to statistical significance. Conclusion: There<br />is a need for proper definition of the problem of childhood cancer patients so that appropriate policy can be introduced<br />to improve survival by improving treatment compliance.