(HealthDay News) — Patients with cancer who receive complementary medicine (CM) are more likely to refuse conventional cancer treatment (CCT), according to a study published online in JAMA Oncology.

Skyler B. Johnson, MD, from the Yale School of Medicine in New Haven, Conn., and colleagues conducted a retrospective observational study using data from the National Cancer Database on 1,901,815 patients diagnosed with non-metastatic breast, prostate, lung, or colorectal cancer. Overall survival was compared between patients receiving CCT with or without CM (258 and 1,901,557, respectively).

Following matching, 258 patients in the CM group and 1032 in the control group were included in analyses. The researchers found that patients who chose CM did not have a longer delay to CCT initiation but did have significantly higher rates of refusal of surgery (7.0 vs 0.1%), chemotherapy (34.1 vs 3.2%), radiotherapy (53.0 vs 2.3%), and hormone therapy (33.7 vs 2.8%). Compared with no CM, use of CM correlated with poorer 5-year overall survival (82.2 vs 86.6%) and was independently linked to elevated risk of mortality (hazard ratio, 2.08), in a multivariate model. Once treatment delay or refusal was included in the model there was no significant correlation seen between CM and survival.

“The results suggest that mortality risk associated with CM was mediated by the refusal of CCT,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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Johnson SB, Park HS, Gross CP, et al.Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers. JAMA Oncol. Published online July 19, 2018. DOI:10.1001/jamaoncol.2018.2487