title: Reasons for Chemotherapy Refusal or Acceptance in Older Adults With Cancer.
abstract: OBJECTIVE
  The majority of Americans diagnosed as having cancer are older than 65 years. They are, however, less likely than younger patients to receive chemotherapy. Our study aimed to better understand the specific reasons for acceptance or refusal of chemotherapy in older adults with cancer.
  
  
  METHODS
  An anonymous cross-sectional survey was distributed during a 6-month study period in a cancer center and an outpatient geriatric medicine faculty practice to patients at least 50 years old with cancer or to their family members. Data collected included reasons for refusal or acceptance, stage/type of cancer, and demographics. The association between chemotherapy refusal or initiation and these factors was assessed using the Fisher exact test.
  
  
  RESULTS
  Among the 37 respondents meeting the inclusion criteria, 78.4% were patients and 21.6% were family members. The following factors were significantly associated with chemotherapy decision: perceived chemotherapy benefit (P< 0.001), trust in the doctor's recommendation (P= 0.013), social support (P= 0.018), marital status (P< 0.001), sex (P= 0.037), race/ethnicity (P= 0.021), and whether respondents had a family member or friend who had previously received chemotherapy (P= 0.040). In contrast, none of the clinical variables, such as stage of cancer, previous receipt of chemotherapy, or interest in complementary/alternative medicine showed significant association with a patient's decision to accept or refuse chemotherapy treatment.
  
  
  CONCLUSIONS
  Chemotherapy decisions made by older adults appear to be associated with demographic and social factors rather than with medical information. Recognizing the influence of these factors for older patients with cancer may help hematologists and oncologists to proactively address specific barriers and explore concerns regarding chemotherapy in older patients whose quality of life and longevity may be affected by treatment.
authors.affiliation: From the Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, Department of Medicine, Northwell Health, Great Neck, the Division of Hematology and Medical Oncology, North Shore-Long Island Jewish Cancer Institute, Lake Success, Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, and the Division of Biostatistics, Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Naveen
authors.initials: N
authors.lastname: Gopal
authors.affiliation: From the Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, Department of Medicine, Northwell Health, Great Neck, the Division of Hematology and Medical Oncology, North Shore-Long Island Jewish Cancer Institute, Lake Success, Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, and the Division of Biostatistics, Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kozikowski
authors.affiliation: From the Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, Department of Medicine, Northwell Health, Great Neck, the Division of Hematology and Medical Oncology, North Shore-Long Island Jewish Cancer Institute, Lake Success, Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, and the Division of Biostatistics, Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Myra F
authors.initials: MF
authors.lastname: Barginear
authors.affiliation: From the Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, Department of Medicine, Northwell Health, Great Neck, the Division of Hematology and Medical Oncology, North Shore-Long Island Jewish Cancer Institute, Lake Success, Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, and the Division of Biostatistics, Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Joanna
authors.initials: J
authors.lastname: Fishbein
authors.affiliation: From the Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, Department of Medicine, Northwell Health, Great Neck, the Division of Hematology and Medical Oncology, North Shore-Long Island Jewish Cancer Institute, Lake Success, Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, and the Division of Biostatistics, Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Renee
authors.initials: R
authors.lastname: Pekmezaris
authors.affiliation: From the Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, Department of Medicine, Northwell Health, Great Neck, the Division of Hematology and Medical Oncology, North Shore-Long Island Jewish Cancer Institute, Lake Success, Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, and the Division of Biostatistics, Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Gisele
authors.initials: G
authors.lastname: Wolf-Klein
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012944:Social Support; D016312:Treatment Refusal / Q000523:psychology
chemical_list: D000970:Antineoplastic Agents