Amini A, Verma V, Li R, et al. - Researchers conducted this investigation to assess the national rate of treatment refusal in head and neck cancer (HNC). For nonmetastatic squamous cell carcinoma of the head and neck, the National Cancer Database was queried. It was estimated that 2,965 patients had refused definitive therapy compared with the 230,424 patients who received treatment. Older age, female sex, African-American/other race, nonprivate insurance, greater comorbidities, more advanced disease, and residence closer to the treating facility were predictors included in this analysis. Patients with a prior cancer history, Hispanic race, those treated at academic centers, and those from higher-income counties were less likely to refuse therapy. Poorer survival was experienced by patients who refused definitive therapy. It is relatively rare in HNC to refuse oncologic therapy and tends to be multifocal in nature.