Palliative Care Use Among Patients With Solid Cancer Tumors: A National Cancer Data Base Study

Osayande Osagiede, Dorin T. Colibaseanu, Aaron Spaulding, Ryan D. Frank, Amit Merchea, Scott R. Kelley, Ryan J. Uitti, Sikander Ailawadhi

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
JournalJournal of Palliative Care
DOIs
StateAccepted/In press - Jan 1 2018

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Palliative Care
Databases
Neoplasms
Lung Neoplasms
Melanoma
Prostatic Neoplasms
Insurance Coverage
Patient Preference
Colonic Neoplasms
Comorbidity
Colon
Breast
Logistic Models
Breast Neoplasms
Survival

Keywords

  • National Cancer Data Base
  • palliative care
  • palliative care underutilization
  • retrospective studies
  • solid tumors. palliative care use in cancer

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Palliative Care Use Among Patients With Solid Cancer Tumors : A National Cancer Data Base Study. / Osagiede, Osayande; Colibaseanu, Dorin T.; Spaulding, Aaron; Frank, Ryan D.; Merchea, Amit; Kelley, Scott R.; Uitti, Ryan J.; Ailawadhi, Sikander.

In: Journal of Palliative Care, 01.01.2018.

Research output: Contribution to journalArticle

Osagiede, Osayande ; Colibaseanu, Dorin T. ; Spaulding, Aaron ; Frank, Ryan D. ; Merchea, Amit ; Kelley, Scott R. ; Uitti, Ryan J. ; Ailawadhi, Sikander. / Palliative Care Use Among Patients With Solid Cancer Tumors : A National Cancer Data Base Study. In: Journal of Palliative Care. 2018.
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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.",
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AU - Frank, Ryan D.

AU - Merchea, Amit

AU - Kelley, Scott R.

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N2 - 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.

AB - 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.

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