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Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities.

Publication ,  Journal Article
Chino, F; Kamal, AH; Leblanc, TW; Zafar, SY; Suneja, G; Chino, JP
Published in: Cancer
November 15, 2018

BACKGROUND: Place of death is an essential component of high quality cancer care and comprehensive national trends and disparities in place of death are unknown. METHODS: Deidentified death certificate data were obtained via the National Center for Health Statistics. All cancer deaths from 1999 through 2015 were included. Multivariate logistic regression was used to test for disparities in place of death associated with sociodemographic variables. RESULTS: From 1999 through 2015, a total of 9,646,498 cancer deaths occurred. Hospital deaths decreased (from 36.6% to 24.6%), whereas the rate of home deaths (38.4% to 42.6%) and hospice facility deaths (0% to 14.0%) both increased (all P<.001). On multivariate logistic regression, all assessed variables were found to be associated with place of death. Specifically, younger age (age birth-14 years: odds ratio [OR], 2.39; age 25-44 years: OR, 1.62), black (OR, 1.83) or Asian (OR, 1.74) race, and Hispanic ethnicity (OR, 1.41) were associated with hospital death. Being married (OR, 2.17) or widowed (OR, 1.56) was associated with home death whereas increasing educational level (OR, 1.15-1.19) was associated with hospice death (all P<.001). Despite overall improvements, certain disparities were found to increase. For young patients, the likelihood of a hospital death increased from 2.3 times to 3.4 times that of older patients (50.9% for those aged 15-24 years vs 15.0% for those aged ≥85 years in 2015). For black patients, the likelihood of a hospital death increased from 1.29 times to 1.42 times that of white patients (32.8% for black patients vs 23.1% for white patients in 2015). CONCLUSIONS: Hospital cancer deaths decreased by approximately one-third with commensurate increases in home and hospice facility deaths. Many sociodemographic groups experience significant disparities with regard to place of death and may benefit from targeted efforts to improve goal-concordant care.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

November 15, 2018

Volume

124

Issue

22

Start / End Page

4408 / 4419

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Socioeconomic Factors
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Chino, F., Kamal, A. H., Leblanc, T. W., Zafar, S. Y., Suneja, G., & Chino, J. P. (2018). Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities. Cancer, 124(22), 4408–4419. https://doi.org/10.1002/cncr.31737
Chino, Fumiko, Arif H. Kamal, Thomas W. Leblanc, S Yousuf Zafar, Gita Suneja, and Junzo P. Chino. “Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities.Cancer 124, no. 22 (November 15, 2018): 4408–19. https://doi.org/10.1002/cncr.31737.
Chino F, Kamal AH, Leblanc TW, Zafar SY, Suneja G, Chino JP. Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities. Cancer. 2018 Nov 15;124(22):4408–19.
Chino, Fumiko, et al. “Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities.Cancer, vol. 124, no. 22, Nov. 2018, pp. 4408–19. Pubmed, doi:10.1002/cncr.31737.
Chino F, Kamal AH, Leblanc TW, Zafar SY, Suneja G, Chino JP. Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities. Cancer. 2018 Nov 15;124(22):4408–4419.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

November 15, 2018

Volume

124

Issue

22

Start / End Page

4408 / 4419

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Socioeconomic Factors
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
  • Logistic Models
  • Humans