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Racial disparities in palliative care utilization among metastatic gynecological cancer patients living at last follow-up: An analysis of the National Cancer Data Base.

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

The National Comprehensive Cancer Network recommends palliative care should be integrated in to cancer care starting from cancer diagnosis. However, traditionally palliative care is prioritized for cancer patients at the end-of-life. In our main article titled "Racial and Ethnic Disparities in Palliative Care Utilization Among Gynecological Cancer Patients" we present data describing racial/ethnic disparities among metastatic gynecological cancer patients who were deceased at last follow-up. Here, we expand our population to evaluate racial disparities in palliative care utilization among (1) all metastatic gynecologic cancer patients, regardless of vital status (alive or deceased) (n = 176,899) and (2) among only patients who were alive at last follow-up (n = 66,781). 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. Palliative care 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 palliative care use among our two populations of interest. Overall, the mean age of gynecologic cancer patients utilizing palliative care was 66 years. Five percent of all metastatic gynecologic oncology patients utilized palliative care overall; and by cancer site palliative care use was as follows: 4% among ovarian, 9% among cervical, and 11% among uterine cancer patients. Among patients who utilized palliative care, 62% utilized surgery, radiation or chemotherapy only and 12% utilized pain management as a form of palliative care. Among ovarian cancer patients, Hispanic ovarian cancer patients were less likely to utilize palliative care compared to their NH-White counterparts (aOR: 0.79, 95% CI: 0.68-0.91). Among cervical cancer patients, we observed that Hispanic (aOR: 0.65, 95% CI: 0.56-0.75) and Asian (aOR: 0.74, 95% CI: 0.59-0.93) were less likely to utilize palliative care than NH-White cervical cancer patients. We observed no racial disparities in palliative care utilization among uterine cancer patients. When we focused on patients who were alive at last follow-up we found that only 3% of patients utilized palliative care. We also conducted multivariable analyses of racial/ethnic disparities among ovarian and cervical cancer patients who were alive at last follow-up. We were unable to conduct multivariable analyses of uterine cancer patients who were alive at last follow-up due to limited sample size of those who utilized palliative care. We observed no racial/ethnic disparities among this patient population of metastatic gynecologic patients.

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Published In

Data Brief

DOI

EISSN

2352-3409

Publication Date

February 2021

Volume

34

Start / End Page

106705

Location

Netherlands
 

Citation

APA
Chicago
ICMJE
MLA
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Islam, J. Y., Deveaux, A., Previs, R. A., & Akinyemiju, T. (2021). Racial disparities in palliative care utilization among metastatic gynecological cancer patients living at last follow-up: An analysis of the National Cancer Data Base. Data Brief, 34, 106705. https://doi.org/10.1016/j.dib.2020.106705
Islam, Jessica Y., April Deveaux, Rebecca A. Previs, and Tomi Akinyemiju. “Racial disparities in palliative care utilization among metastatic gynecological cancer patients living at last follow-up: An analysis of the National Cancer Data Base.Data Brief 34 (February 2021): 106705. https://doi.org/10.1016/j.dib.2020.106705.
Islam, Jessica Y., et al. “Racial disparities in palliative care utilization among metastatic gynecological cancer patients living at last follow-up: An analysis of the National Cancer Data Base.Data Brief, vol. 34, Feb. 2021, p. 106705. Pubmed, doi:10.1016/j.dib.2020.106705.
Journal cover image

Published In

Data Brief

DOI

EISSN

2352-3409

Publication Date

February 2021

Volume

34

Start / End Page

106705

Location

Netherlands