title: Untreated head and neck cancer in Korea: a national cohort study.
abstract: Few studies have analyzed the survival of patients with untreated head and neck cancer. The objective of this study is to assess the survival rates of untreated head and neck cancer patients and to determine why the patients were not treated. Using data from a national patient sample cohort (1,025,340 cases) from the Korean Health Insurance Review and Assessment Service, 605 patients with diagnoses of head and neck cancer (lip and oral cavity, oropharynx, hypopharynx, and laryngeal cancer) between 2003 and 2013 were evaluated. Cox proportional hazards modeling and multiple logistic regression analysis were performed. Of the considered cases of head and neck cancer, 32.2% were untreated. The median survival rate of untreated groups was 9 months. The untreated group showed poorer survival than the treatment groups. Old age [adjusted odds ratio (AOR) = 1.37, 95% confidence internal (CI) 1.25-1.49, P < 0.001] and low income (AOR = 0.94, 95% CI 0.89-1.00, P = 0.028) were related to not receiving treatment. Many head and neck cancers go untreated. Clinicians should focus on untreated patients and seek to understand the reasons for their lack of treatment.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea.
authors.forename: Hyo Geun
authors.initials: HG
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea.
authors.forename: Bumjung
authors.initials: B
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Republic of Korea. ahnsh30@snu.ac.kr.
authors.forename: Soon-Hyun
authors.initials: SH
authors.lastname: Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate; D016312:Treatment Refusal; D055815:Young Adult
keywords: Head and neck neoplasms; Mortality; Survival; Therapy; Treatment refusal