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Original article Changes in the treatment rate of patients newly diagnosed with stage IV cancer near the end of life from 2012 to 2017 in Korea
Kyuwoong Kim1orcid , Hyun Jung Jho1,2orcid , So Jung Park1,2orcid , Bohyun Park1orcid , Jin Young Choi1orcid
Epidemiol Health 2022;e2023021
DOI: https://doi.org/10.4178/epih.e2023021 [Accepted]
Published online: February 14, 2023
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1National Hospice Center, National Cancer Control Institute, Goyang, Korea, Goyang, Korea
2Department of Hospice Palliative Service, National Cancer Center, Goyang, Korea
Corresponding author:  Jin Young Choi,
Email: ilotopie@ncc.re.kr
Received: 25 November 2022   • Revised: 30 January 2023   • Accepted: 31 January 2023
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Abstract

Objectives
This study aimed to evaluate changes in the cancer treatment rate among patients newly diagnosed with stage IV cancer using sociodemographic and clinical subgroups in a nationwide cohort of Korean patients.
Methods
This retrospective, national-level study used the Korea Central Cancer Registry (KCCR), which is linked to the National Health Insurance Service (NHIS) database, from January 1, 2012 to December 31, 2017. The records of patients newly diagnosed with stage IV of the 5 cancers with the highest cancer-related mortality rate were identified to analyze changes in the treatment rate. The main outcome examined in this study was the change in the cancer treatment rate between 2012 and 2017, as measured using the annual percent change (APC).
Results
A total of 106,082 patients with newly diagnosed gastric, colorectal, liver, pancreatic, and lung cancers at the end of life (EoL) were identified from the KCCR-NHIS database. Of these patients, 76,533 (72.1%) received cancer treatment. Over the study period (2012–2017), the proportion of patients who received cancer treatment at EoL decreased by 8.3%, with an APC of -2.1% (95% confidence interval, -2.6% to -1.6%). This declining trend of cancer treatment among patients with advanced cancer stage at EoL was consistent among sociodemographic and clinical subgroups.
Conclusions
The proportion of untreated patients with stage IV cancer is increasing in the Republic of Korea. For patients who are not undergoing standard cancer treatment near EoL, an alternative care plan, such as early palliative care, should be considered.

Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.