Alexander C. Small, of the Mount Sinai School of Medicine in New York City, and associates queried the National Cancer Data Base to identify patients diagnosed with metastatic solid tumors who received neither radiotherapy nor systemic therapy between 2000 and 2008.

The researchers identified 773,233 patients, of whom 20.6 percent received no anticancer treatment. Fifty-five percent of the untreated population was made up of patients with non-small-cell lung cancer. The highest rates of no treatment were seen for patients with cancers of the kidney (25.5 percent) and lung (24 percent), and the lowest rate of no treatment was seen for patients with prostate cancer (11.1 percent). Factors significantly associated with no treatment across all cancer types included older age (prevalence ratio [PR] range, 1.37 to 1.49), black race (PR range, 1.05 to 1.32), lack of medical insurance (PR range, 1.47 to 2.46), and lower income for all cancers except uterine (PR range, 0.91 to 0.98 for every $10,000 increase in income).

"A large percentage of patients presenting with advanced solid tumors at the time of their initial cancer diagnosis receive no anticancer therapy," the authors write. "Further studies are necessary to better define the reasons for this lack of treatment, particularly because these relate to access to care, health literacy, and treatment disparities."

One author disclosed financial ties to the pharmaceutical industry.

Abstract
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