Palliative Care Use Among Patients With Solid Cancer Tumors: A National Cancer Data Base Study.
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.
['Osagiede|Osayande|O|', 'Colibaseanu|Dorin T|DT|', 'Spaulding|Aaron C|AC|', 'Frank|Ryan D|RD|', 'Merchea|Amit|A|', 'Kelley|Scott R|SR|', 'Uitti|Ryan J|RJ|', 'Ailawadhi|Sikander|S|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D009369:Neoplasms D010166:Palliative Care D012189:Retrospective Studies D014481:United States
palliative care National Cancer Data Base palliative care underutilization retrospective studies solid tumors. palliative care use in cancer