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

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.

Deciphering the Patterns of Dual Primary Cases Registered at the Hospital-Based Cancer Registry: First Experience from Rural Cancer Center in North India

“…2) was breast (15 cases; 33.3%) followed by head and neck (H&N) cancer (10 cases; 22.2%), gynecological cancer (5 cases; 11.1%), prostate cancer (4 cases; 8.9%), esophagus cancer (2 cases; 4.4%), and other sites (9 cases; 20.0%) which are also in the top leading sites in males and females in HBCR. 22 The most common site for second malignancy (►Fig. 3) was the gastrointestinal tract (GI tract) (14 cases; 31.1%) followed by gynecological cancer (8 cases; 17.8%), H&N (7 cases 15.6%), hematological (3 cases; 6.7%), soft tissue sarcoma (STS) (2 cases; 4.4%), breast (1 case; 2.2%), and other sites (10 cases; 22.2%).…”

“…2 ) was breast (15 cases; 33.3%) followed by head and neck (H&N) cancer (10 cases; 22.2%), gynecological cancer (5 cases; 11.1%), prostate cancer (4 cases; 8.9%), esophagus cancer (2 cases; 4.4%), and other sites (9 cases; 20.0%) which are also in the top leading sites in males and females in HBCR. 22 …”

Histopathological changes in gall bladder mucosa in relation to the number, and size of gallstones, and analysis of the findings in the context of age distribution of the patients: A perspective

“…High use of pesticides, presence of toxic material also in sub-soil water, leaching of uranium from rocks, and presence of thermal power plants based on coal are thought to the reasons for the high incidence of cancer in the state of Punjab, India. The work of Aggarwal et al [29] on the pattern of cancer incidence in the Malwa region of the Punjab, was published in March 2015, demonstrated breast cancer to be the leading cancer (35%) among all cancer cases, (most common), and 4% cases were of gall bladder cancer (fifth highest cases), whereas in a recent study published November 2021 by Budukh et al [30] on cancer cases reported in the Homi Bhaba cancer institute, Sangrur reported GB cancer being the 3rd most common cancer (7.9%). Here we can observe that the proportion of gall bladder cancer cases among all cancer cases significantly increased from 4% to almost 7.9% in the north Indian region of Punjab over a period of few years.…”

Overall survival of prostate cancer from Sangrur and Mansa cancer registries of Punjab state, India

“…According to data from various hospital-based cancer registries in India, 50%–60% of cancer patients did not complete cancer-directed treatment. [ 28 29 ] However, we would like to emphasize and acknowledge the limitation that, based on the study results, the disease was most likely metastatic, and treatment for such patients is lifelong. Clinically, the completion of treatment is not relevant; however, from the epidemiological perspective, these findings would be useful for developing public health strategies to improve treatment completion.…”