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Reasons for not receiving standard of care treatment and effectiveness of capecitabine in stage III colon cancer patients in Alberta Open Access


Other title
adjuvant chemotherapy
colon cancer
comparative effectiveness
standard of care
Type of item
Degree grantor
University of Alberta
Author or creator
El Shayeb, Mohamed
Supervisor and department
Macy Winget (Cancer Care, Alberta Health Services)
Yutaka Yasui (School of Public Health)
Examining committee member and department
Andrew Scarfe (Faculty of Medicine and Dentistry, Cross Cancer Institute)
Marcy Winget (Cancer Care, Alberta Health Services)
Yutaka Yasui ( School of Public Health)
School of Public Health Sciences

Date accepted
Graduation date
Master of Science
Degree level
Adjuvant chemotherapy is the standard of care for stage-III colon cancer. Despite this, large proportions of patients do not receive it; the oncologist may not recommend it or the patient may refuse it. We aimed to identify the physicians’ and patients’ reasons for making treatment decisions. We also evaluated the effectiveness of newly-introduced capecitabine in real clinical practice. A retrospective population-based study was conducted that included all surgically-treated stage-III colon cancer patients in Alberta between 2002 and 2005 who had consultation with an oncologist. Chart reviews were conducted to extract treatment details, oncologists’ reasons for not recommending, and patients’ reasons for declining chemotherapy. A total of 613 patients met the inclusion criteria. Overall, 27% of the patients did not receive chemotherapy. The most frequent reason for not recommending chemotherapy was co-morbidity. Twenty-two percent of patients declined treatment due to toxicity concerns. Effectiveness results of capecitabine conformed to its efficacy.
License granted by Mohamed El Shayeb ( on 2011-09-29T15:28:27Z (GMT): Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of the above terms. The author reserves all other publication and other rights in association with the copyright in the thesis, and except as herein provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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