Determinants of completion of cancer directed treatment: an experience from a rural cancer centre, Sangrur, Punjab state, India.

Atul M Budukh,Rajesh P Dikshit,Shraddha Shinde,Tapas Dora,Rakesh Kapoor,Prithviraj Kadam,Alok Kumar Goel,Debashish Chaudhary,Sankalp Sancheti,Rajendra A Badwe,Akash Sali,Anshul Singla,Pankaj Chaturvedi,Raza Mohammad,Kuldeep Singh Chauhan

doi:10.3332/ecancer.2021.1313

Abstract

In low and middle-income countries, access to cancer diagnosis and treatment is suboptimal. Further, compliance to cancer treatment is a major issue due to various reasons including financial barriers, lack of family support and fear of treatment. This article discusses the determinants of treatment completion in cancer patients of a government-run hospital, in a rural part of Punjab in India. The Sangrur hospital-based cancer registry data for the year 2018 have been used. We have registered 2,969 cancer cases, out of which 2,528 (85%) cases were eligible for the analysis. Of the total 2,528 cases, 1,362 (54%) cases completed the cancer directed treatment and 1,166 (46%) did not. The data have been collected from the electronic medical record (EMR) department and entered into CanReg5 software. The bivariate and multivariate binary logistic regression analysis was performed to see the effect of variables on the treatment completion. The results indicate that the elderly age group (>60 years) (odds ratio (OR): 0.52, (95% confidence interval (CI): 0.31–0.86)), distance from hospital (OR: 0.67, (95% CI: 0.50–0.89)) and access to government health schemes (OR: 0.13, (95% CI: 0.10–0.19)] have direct correlation with the treatment completion. The educated patients (OR: 1.49, (95% CI: 1.13–1.96)) and patients who received curative treatment (OR: 2.7, (95% CI: 1.88–3.88)) have shown 58% and 84% compliance to treatment completion, respectively. The other variables like the clinical extent of disease, religion, gender and income do not have any significant effect on the treatment completion. Determinants like age (young), education, distance from the hospital, curative treatment and availability of government health schemes for financial support have shown positive effects on treatment completion. These factors have to be considered by the cancer hospitals, health departments and policymakers while planning for cancer care or control in India.

Highlights

Cancer is the leading cause of death globally accounting for 10 million deaths per year
The data are taken from the hospital-based cancer registry (HBCR) of Homi Bhabha Cancer Hospital (HBCH), Sangrur, Punjab, India
HBCH is established by Tata Memorial Centre (TMC), Mumbai, with the support of Punjab government in the rural area of the Punjab state, which is around 125 km from Chandigarh Union Territory

Summary

Introduction

Cancer is the leading cause of death globally accounting for 10 million deaths per year. As per the hospital-based cancer registries report (2012–2014) of India, the no cancer-directed treatment was in the range of 17%–60% and 15%–50% in males and females, respectively [3]. The percentage of patients who haven’t completed the treatment is high and it has negative effect on the survival rate and quality of life. Several factors such as financial constraints, lack of family support and fear of radiotherapy (RT) treatment affect the treatment completion in cancer patients [4,5,6]. The data are taken from the hospital-based cancer registry (HBCR) of Homi Bhabha Cancer Hospital (HBCH), Sangrur, Punjab, India.

Methods

Results

Discussion

Conclusion