Treatment preferences and completion rates among oncology patients from Amish communities.

194 Background: There are no published studies on oncology treatment preferences in patients from Amish communities. Methods: A retrospective study was conducted using the cancer registry and EMR review. Patients newly diagnosed with cancer at our institution from 1/1/2008 to 5/31/2024 and identified as Amish were included and matched to non-Amish controls. The primary endpoint was completion of standard of care (SOC) treatment. Secondary goals included identifying predictors of treatment completion and reasons for non-completion. Two independent reviewers assessed care and outcomes. SOC was determined by specialist experts. Statistical analysis was performed using R, with significance at p < 0.05. Results: We identified 38 Amish patients and 37 matched non-Amish controls. Among Amish patients with curable cancers, only 48% completed all SOC treatments compared to 91% of controls (p< 0.01), Table 1, with the largest difference being the lower acceptance of chemotherapy as a modality. For patients with curable cancers, Amish men were more likely to complete SOC than Amish women (p = 0.01). Age, marital status, and cancer type were not associated with treatment completion. Amish patients with metastatic cancer remained less likely to complete all SOC treatments (p < 0.01) or chemotherapy (p < 0.01). No significant differences were found in surgery, radiation, or hormone therapy completion. Common reasons for declining SOC were a preference for natural therapies and costs. Conclusions: This is the first study to describe oncology treatment completion patterns in the Amish community. The lower completion rates among Amish patients suggest a complex interplay of cultural, economic, and gender-specific factors. Cost concerns and preference for natural therapies were frequently cited as reasons for non-completion, emphasizing the need for culturally sensitive communication and financial counseling. While men were more likely to have cancers that were treated with surgery or hormones, it is unclear if this completely explains the observed gender disparity. While many questions remain, this study provides a groundwork to evaluate other aspects of oncologic care such as gender roles, autonomy, and access to care within Amish communities. We plan to carry out Amish focus groups to better understand community-specific needs regarding cancer treatment. These findings have practical implications for oncology teams aiming to deliver personalized, culturally informed care and improve cancer care outcomes in Amish populations. Completion of recommended curative intent treatment by modality. Treatment Modality Amish Patients Non-Amish Controls p-value All SOC 10/21 (48%) 21/23 (91%) P <0.01 Chemotherapy 5/15 (33%) 14/15 (93%) P < 0.01 Surgery 14/17 (82%) 18/19 (95%) P = 0.30 Radiation 5/12 (42%) 9/12 (75%) P = 0.10 Hormone Therapy 5/7 (71%) 5/10 (50%) P = 0.60 Surveillance 6/18 (33%) 15/17 (88%) P < 0.01