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Racial and ethnic disparities in palliative care utilization among gynecological cancer patients.

Publication ,  Journal Article
Islam, JY; Deveaux, A; Previs, RA; Akinyemiju, T
Published in: Gynecol Oncol
February 2021

BACKGROUND: Palliative care (PC) is recommended for gynecological cancer patients to improve survival and quality-of-life. Our objective was to evaluate racial/ethnic disparities in PC utilization among patients with metastatic gynecologic cancer. METHODS: We used data from the 2016 National Cancer Database (NCDB) and included patients between ages 18-90 years with metastatic (stage III-IV) gynecologic cancers including, ovarian, cervical and uterine cancer who were deceased at last contact or follow-up (n = 124,729). PC was defined by NCDB as non-curative treatment, and could include surgery, radiation, chemotherapy, and pain management or any combination. We used multivariable logistic regression to evaluate racial disparities in PC use. RESULTS: The study population was primarily NH-White (74%), ovarian cancer patients (74%), insured by Medicare (47%) or privately insured (36%), and had a Charlson-Deyo score of zero (77%). Over one-third of patients were treated at a comprehensive community cancer program. Overall, 7% of metastatic gynecologic deceased cancer patients based on last follow-up utilized palliative care: more specifically, 5% of ovarian, 11% of cervical, and 12% of uterine metastatic cancer patients. Palliative care utilization increased over time starting at 4% in 2004 to as high as 13% in 2015, although palliative care use decreased to 7% in 2016. Among metastatic ovarian cancer patients, NH-Black (aOR:0.87, 95% CI:0.78-0.97) and Hispanic patients (aOR:0.77, 95% CI:0.66-0.91) were less likely to utilize PC when compared to NH-White patients. Similarly, Hispanic cervical cancer patients were less likely (aOR:0.75, 95% CI:0.63-0.88) to utilize PC when compared to NH-White patients. CONCLUSIONS: PC is highly underutilized among metastatic gynecological cancer patients. Racial disparities exist in palliative care utilization among patients with metastatic gynecological cancer.

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Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

February 2021

Volume

160

Issue

2

Start / End Page

469 / 476

Location

United States

Related Subject Headings

  • Young Adult
  • White People
  • United States
  • Patient Acceptance of Health Care
  • Palliative Care
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Medicare
  • Humans
 

Citation

APA
Chicago
ICMJE
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Islam, J. Y., Deveaux, A., Previs, R. A., & Akinyemiju, T. (2021). Racial and ethnic disparities in palliative care utilization among gynecological cancer patients. Gynecol Oncol, 160(2), 469–476. https://doi.org/10.1016/j.ygyno.2020.11.031
Islam, Jessica Y., April Deveaux, Rebecca A. Previs, and Tomi Akinyemiju. “Racial and ethnic disparities in palliative care utilization among gynecological cancer patients.Gynecol Oncol 160, no. 2 (February 2021): 469–76. https://doi.org/10.1016/j.ygyno.2020.11.031.
Islam JY, Deveaux A, Previs RA, Akinyemiju T. Racial and ethnic disparities in palliative care utilization among gynecological cancer patients. Gynecol Oncol. 2021 Feb;160(2):469–76.
Islam, Jessica Y., et al. “Racial and ethnic disparities in palliative care utilization among gynecological cancer patients.Gynecol Oncol, vol. 160, no. 2, Feb. 2021, pp. 469–76. Pubmed, doi:10.1016/j.ygyno.2020.11.031.
Islam JY, Deveaux A, Previs RA, Akinyemiju T. Racial and ethnic disparities in palliative care utilization among gynecological cancer patients. Gynecol Oncol. 2021 Feb;160(2):469–476.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

February 2021

Volume

160

Issue

2

Start / End Page

469 / 476

Location

United States

Related Subject Headings

  • Young Adult
  • White People
  • United States
  • Patient Acceptance of Health Care
  • Palliative Care
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Medicare
  • Humans