Abstract:
Background: Anti-cancer therapy is vital to mitigate and/or irrigate the cancers and treatment
default affects the progression of disease manifestation. Identification of factors that contributes
to default treatment is important to improve survival rate and quality of life.
Objectives: To identify factors associated with treatment default among patients with cancer
during the COVID-19 pandemic at the National Cancer Institute Sri Lanka.
Methods: A descriptive cross-sectional study was carried out among randomly selected 250
adult patients with cancers attending the National Cancer Institute, Sri Lanka from November
2021 to January 2022. A pre-tested, interviewer-administered questionnaire was used to collect
data. It consisted of baseline characteristics, cancer-related details, and factors that contribute to
default treatment. Data were analysed using SPSS version 25.0 and Minitab version 18.0.
Results: Mean (SD) age of participants is 53.18 (7.32) years old. The majority were male
(57.6%), and non-employed (65.2%). Commonest cancers among study population included
breast (20.4%), blood (16%), colon (14.4%), and lung (12.8%). About 90% of patients received
chemotherapy and approximately 50% of the patients received radiotherapy and surgery.
Reliability and validity requirements included Cronbach's Alpha=0.527, KMO value=0.702,
Bartlett's test p<0.001 at 95% CI). Based on factor analysis, 16 factors contributing to default
treatment were reduced to five common factors. Those common factors included; patient
experience, suicidal ideas, COVID-19 and financial issues, ambulation, transport facilities, and
other patient-related factors. Age was associated with patient experience (p=0.013), ambulation
and transport facilities (p=0.006), having suicidal ideas (p=0.001), termination of cancer
treatment (p=0.027). The level of education was associated with the patient experience
(p<0.001), suicidal ideas (0.030), and termination of cancer treatment (p=0.008). Income was
associated with the termination (p=0.003) and delaying treatment (p=0.023).
Conclusions: Age, level of income, and education were associated with delaying and
termination of ant-cancer treatment. Strategies are needed to minimize the default anti-cancer
treatment during the COVID-19 pandemic.
