J Gastric Cancer.  2019 Mar;19(1):92-101. 10.5230/jgc.2019.19.e5.

Trends and Outcomes of Non-compliance with Treatment for Gastric Cancer in Korea over the 16 years from 1999 to 2015

• Eom BW
• Jung KW
• Won YJ
• Kim YW

• KMID: 2458821
• DOI: http://doi.org/10.5230/jgc.2019.19.e5

Abstract

PURPOSE
The aim of this study was to evaluate the trend of non-compliance with treatment (NCT) among gastric cancer patients in the Korean population.
MATERIALS AND METHODS
Using data from the Korea Central Cancer Registry from 1999 to 2015, patients who did not receive any treatment for gastric cancer within 4 months after diagnosis were defined as the NCT group. The annual incidence rate, distributions according to age group and stage, and 5-year relative survival of the patients exhibiting NCT were analyzed.
RESULTS
The number of NCT patients was 5,871 (30.6%) in 1999 and continuously decreased to 4,434 (15.3%) in 2015. Between 2006 and 2015, the proportions of NCT patients decreased from 72.9% to 55.0% among those 80 years old or older and from 9.2% to 5.4% among patients younger than 40 years. In patients with distant metastases, this proportion decreased from 35.5% to 32.7%, and this proportion also decreased from 17.6% to 8.2% among those with localized disease. The 5-year relative survival rates of NCT patients between 2011 and 2015 were significantly lower than those of the treated patients in each stage (60.2% vs. 99.7%, 13.8% vs. 67.1%, and 2.0% vs. 8.3% among those with localized, regional, and distant disease, respectively).
CONCLUSIONS
The proportion of NCT gastric cancer patients has decreased during the last 16 years. However, considerable numbers of elderly patients are still NCT. There must be a strategy to decrease NCT and improve the nationwide survival rate of patients with gastric cancer.

Keyword

Gastric neoplasm; Patient compliance; Korea

MeSH Terms

Aged
Diagnosis
Humans
Incidence
Korea*
Neoplasm Metastasis
Patient Compliance
Stomach Neoplasms*
Survival Rate

Figure

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  Fig. 1 Changes in NCT for gastric cancer between 1999 and 2015. NCT = non-compliance to the treatment.

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  Fig. 2 Relative survival rates between patients who were diagnosed with gastric cancer in 2006–2010 and 2011–2015 according to each SEER stage: (A) overall; (B) localized; (C) regional; (D) distant. NCT = non-compliance to the treatment; SEER = surveillance, epidemiology, and end results.

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