Abstract
Abandonment of treatment is a poorly recognized issue, common in the unique group of Teenage and Young Adults (TYAs) (15-29 y) with cancer. Cancer in this age group causes social and psychological turmoil altering their understanding and perception about the management of cancer. This study is the first-of-its kind in TYAs while there are several pediatric reports on the problem. A retrospective cross-sectional and analytical study was conducted over a period of 18 months from 01st January 2017 to 30thJune 2018 with a 12-month registration period and 6 months of follow up at four cancer centers in Rajasthan (3) and Madhya Pradesh (1). A total of 1310 TYA cancer patients’ charts were analyzed to study the influence of demographic and disease-related characteristics associated with the abandonment of treatment in TYAs with cancer. Complete data of 807 patients (55.8%) was collected. Factors leading to abandonment were analyzed, and the salient conclusions are that - Total of 650 patients (80.5%) were from the rural background and most of the patients (88%) were living more than 200 kilometers from oncology centers. A quarter (24.4%) of all TYAs with cancer abandoned their therapy: mostly students, unemployed and unmarried. Those with bone cancer (37%), brain tumor (31.6%) and leukemia (25.1%) had the highest abandonment rate. Reasons for abandonment identified were financial burden of therapy, followed by the refusal of standard therapy and preference for alternative medicine. Mortality rates were Forty six percent in our study group with similar outcome across all age groups. There were significantly more deaths in patients who abandoned treatment. (30.4% vs 18.6%). Our study has for the first-time quantified abandonment of treatment among TYA cancer patients: a quarter of all cancers. Completing treatment decreases the probability of death from cancer. Conducting a large, community level collaborative study will probably be more informative and could validate these and other characteristics of this unique demographic group of cancer patients, with clues to reduce or prevent abandonment.
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