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

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

doi:10.3332/ecancer.2021.1313

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

Ecancermedicalscience. 2021 Nov 1:15:1313. doi: 10.3332/ecancer.2021.1313. eCollection 2021.

Authors

Atul M Budukh^{1

2}, Debashish Chaudhary^{3

4}, Sankalp Sancheti^{3

5}, Tapas Dora³, Alok Kumar Goel³, Anshul Singla³, Akash Sali³, Shraddha Shinde⁶, Kuldeep Singh Chauhan⁶, Prithviraj Kadam⁶, Raza Mohammad^{6

7}, Rakesh Kapoor^{3

8}, Pankaj Chaturvedi¹, Rajesh P Dikshit^{1

9}, Rajendra A Badwe^{1

10}

Affiliations

¹ Tata Memorial Centre (TMC), Homi Bhabha National Institute (HBNI), E Borges Marg, Mumbai, Maharashtra 400 012, India.
² https://orcid.org/0000-0001-6723-802X.
³ Homi Bhabha Cancer Hospital (HBCH), Civil Hospital Campus, Sangrur, Punjab 148001, India.
⁴ https://orcid.org/0000-0001-8917-678X.
⁵ https://orcid.org/0000-0001-5810-8733.
⁶ Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Mumbai, India.
⁷ https://orcid.org/0000-0001-8316-3435.
⁸ https://orcid.org/0000-0003-3789-1591.
⁹ https://orcid.org/0000-0003-4830-0486.
¹⁰ https://orcid.org/0000-0002-0480-2831.

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.

Keywords: India; cancer care; declining cancer treatment; registry; rural health care; treatment compliance.