Ran LH, Qin CC. Cross-sectional survey of factors influencing treatment adherence in elderly cancer patients in rural mountainous Guangyuan, China. World J Clin Oncol 2026; 17(7): 123983 [DOI: 10.5306/wjco.123983]
Corresponding Author of This Article
Chao-Chao Qin, MD, PhD, Oncology Internal Medicine Treatment Unit, Guangyuan Traditional Chinese Medicine Hospital Affiliated to Chengdu University of Traditional Chinese Medicine, No. 215-1 Jianshe Road, Lizhou District, Guangyuan 628000, Sichuan Province, China. qinchaonannong@163.com
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Ran LH, Qin CC. Cross-sectional survey of factors influencing treatment adherence in elderly cancer patients in rural mountainous Guangyuan, China. World J Clin Oncol 2026; 17(7): 123983 [DOI: 10.5306/wjco.123983]
World J Clin Oncol. Jul 24, 2026; 17(7): 123983 Published online Jul 24, 2026. doi: 10.5306/wjco.123983
Cross-sectional survey of factors influencing treatment adherence in elderly cancer patients in rural mountainous Guangyuan, China
Li-Hua Ran, Chao-Chao Qin
Li-Hua Ran, Department of Abdominal Oncology Ward, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Chao-Chao Qin, Oncology Internal Medicine Treatment Unit, Guangyuan Traditional Chinese Medicine Hospital Affiliated to Chengdu University of Traditional Chinese Medicine, Guangyuan 628000, Sichuan Province, China
Author contributions: Ran LH wrote the main manuscript text; Qin CC reviewed and revised the manuscript. Both authors approved the final version to publish.
AI contribution statement: No artificial intelligence tools were used in the preparation of this manuscript. All content, including study design, data analysis, result interpretation, and manuscript writing, was completed independently by the authors.
Supported by Sichuan Provincial Geriatric Health Development Center and Sichuan Gerontological Society, No. 24SCLN0138.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Guangyuan Hospital of Traditional Chinese Medicine, No. 2024028.
Informed consent statement: Written informed consent was obtained from all study participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets analyzed in this study are available from the corresponding author upon reasonable request.
Corresponding author: Chao-Chao Qin, MD, PhD, Oncology Internal Medicine Treatment Unit, Guangyuan Traditional Chinese Medicine Hospital Affiliated to Chengdu University of Traditional Chinese Medicine, No. 215-1 Jianshe Road, Lizhou District, Guangyuan 628000, Sichuan Province, China. qinchaonannong@163.com
Received: June 4, 2026 Revised: July 10, 2026 Accepted: July 20, 2026 Published online: July 24, 2026 Processing time: 51 Days and 21.4 Hours
Abstract
BACKGROUND
In the rural mountainous areas of Guangyuan, elderly patients with malignant tumors are poorly managed in terms of toxic side effects after comprehensive antitumor therapy, severely affecting their treatment adherence.
AIM
To explore the factors influencing treatment adherence in elderly cancer patients in rural mountainous Guangyuan and clarify the relative importance of each factor.
METHODS
This multicenter cross-sectional survey assessed 103 elderly patients with malignant tumors in rural mountainous areas of Guangyuan who completed core scales. Research tools included the Supportive Care Needs Survey Short Form, the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events, the Comprehensive Score for financial Toxicity, psychological status scales (Hospital Anxiety and Depression Scale/Distress Thermometer/Social Support Rating Scale), and the Medication Adherence Scale. Descriptive statistics, correlation analysis, multiple linear regression, and relative weight analysis were used for data processing.
RESULTS
The average Medication Adherence Scale score was 4.12 ± 1.85 points, with 53.9% of patients having poor treatment adherence. Univariate and correlation analyses showed that supportive care needs, symptom severity, financial toxicity, anxiety/depression, and lack of social support were all significantly correlated with treatment adherence (all P < 0.05). On multivariate analysis, financial toxicity was the primary associated factor (relative weight 28.40%), with direct medical costs having the strongest negative independent association (β = -0.312, P = 0.001). Symptom burden, especially fatigue (β = -0.254, P = 0.002), and psychological status (β = 0.234, P = 0.005) were the second and third most influential factors, respectively, whereas social support was a protective factor. Supportive care needs also had an independent influence. The comprehensive model explained 51.8% of the variance in treatment adherence (R2 = 0.518, P < 0.001).
CONCLUSION
The treatment adherence of elderly patients with malignant tumors in the rural mountainous areas of Guangyuan is jointly influenced by multidimensional factors. Financial toxicity had the strongest association with treatment adherence, while symptom management and psychological support serve as key supporting elements. This study provides a clear direction for the development of precise medical management and policies for this special population and the construction of a comprehensive intervention model.
Core Tip: This study, through a cross-sectional survey, found that the treatment adherence of elderly cancer patients in rural mountainous areas of Guangyuan was generally poor. Economic toxicity was the strongest factor associated with adherence, with direct medical costs having the greatest impact, followed by fatigue symptoms. Social support served as a significant protective factor. The findings provide a basis for developing targeted intervention strategies for patients in this region.
