Osayande Osagiede1, Dorin T Colibaseanu2, Aaron C Spaulding1, Ryan D Frank3, Amit Merchea2, Scott R Kelley4, Ryan J Uitti5, Sikander Ailawadhi6. 1. 1 Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA. 2. 2 Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. 3. 3 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. 4. 4 Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA. 5. 5 Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. 6. 6 Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA.
Abstract
BACKGROUND: Palliative care has been increasingly recognized as an important part of cancer care but remains underutilized in patients with solid cancers. There is a current gap in knowledge regarding why palliative care is underutilized nationwide. OBJECTIVE: To identify the factors associated with palliative care use among deceased patients with solid cancer tumors. METHODS: Using the 2016 National Cancer Data Base, we identified deceased patients (2004-2013) with breast, colon, lung, melanoma, and prostate cancer. Data were described as percentages. Associations between palliative care use and patient, facility, and geographic characteristics were evaluated through multivariate logistic regression. RESULTS: A total of 1 840 111 patients were analyzed; 9.6% received palliative care. Palliative care use was higher in the following patient groups: survival >24 months (17% vs 2%), male (54% vs 46%), higher Charlson-Deyo comorbidity score (16% vs 8%), treatment at designated cancer programs (74% vs 71%), lung cancer (76% vs 28%), higher grade cancer (53% vs 24%), and stage IV cancer (59% vs 13%). Patients who lived in communities with a greater percentage of high school degrees had higher odds of receiving palliative care; Central and Pacific regions of the United States had lower odds of palliative care use than the East Coast. Patients with colon, melanoma, or prostate cancer had lower odds of palliative care than patients with breast cancer, whereas those with lung cancer had higher odds. CONCLUSIONS: Palliative care use in solid cancer tumors is variable, with a preference for patients with lung cancer, younger age, known insurance status, and higher educational level.
BACKGROUND: Palliative care has been increasingly recognized as an important part of cancer care but remains underutilized in patients with solid cancers. There is a current gap in knowledge regarding why palliative care is underutilized nationwide. OBJECTIVE: To identify the factors associated with palliative care use among deceased patients with solid cancer tumors. METHODS: Using the 2016 National Cancer Data Base, we identified deceased patients (2004-2013) with breast, colon, lung, melanoma, and prostate cancer. Data were described as percentages. Associations between palliative care use and patient, facility, and geographic characteristics were evaluated through multivariate logistic regression. RESULTS: A total of 1 840 111 patients were analyzed; 9.6% received palliative care. Palliative care use was higher in the following patient groups: survival >24 months (17% vs 2%), male (54% vs 46%), higher Charlson-Deyo comorbidity score (16% vs 8%), treatment at designated cancer programs (74% vs 71%), lung cancer (76% vs 28%), higher grade cancer (53% vs 24%), and stage IV cancer (59% vs 13%). Patients who lived in communities with a greater percentage of high school degrees had higher odds of receiving palliative care; Central and Pacific regions of the United States had lower odds of palliative care use than the East Coast. Patients with colon, melanoma, or prostate cancer had lower odds of palliative care than patients with breast cancer, whereas those with lung cancer had higher odds. CONCLUSIONS: Palliative care use in solid cancer tumors is variable, with a preference for patients with lung cancer, younger age, known insurance status, and higher educational level.
Entities:
Keywords:
National Cancer Data Base; palliative care; palliative care underutilization; retrospective studies; solid tumors. palliative care use in cancer
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