Disparities in place of death (PoD) in patients with gastrointestinal (GI) cancers.

Authors

S. M. Qasim Hussaini

Syed Hussaini

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD

Syed Hussaini , Nivedita Arora , Ramy Sedhom , Muhammad Shaalan Beg , Arjun Gupta

Organizations

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, University of Minnesota, Minneapolis, MN, University of Pennsylvania, Philadelphia, PA, University of Texas Southwestern Medical Center, Dallas, TX

Research Funding

Conquer Cancer Foundation of the American Society of Clinical Oncology

Background: PoD is an important determinant of patient and caregiver experience. Differences in PoD may reflect disparities in care, including aggressive end-of-life (EOL) care, and access to palliative care/hospice services and caregiver support/resources. We sought to describe sociodemographic disparities in PoD in patients dying from GI cancers between 2003-2019. Methods: We used deidentified death certificate data via the CDC Wonder database. We included decedents with an underlying cause of death of GI cancer (identified through ICD codes) from 2003-2019. We stratified findings by ethnicity, race, gender, and age (< or ≥ 65 years). We classified PoD as (1) medical facility (2) nursing home, (3) home, or (4) hospice facility. We estimated Annual Percentage Change (APC) in PoD across sociodemographic groups. Results: We included 2,347,754 decedents in the analysis (43.6% women, 68.4% ≥65 years, 7.6% Hispanic, 12.7% non-Hispanic Black [NHB], 75.4% non-Hispanic White [NHW]). From 2003– 2019, across all groups, deaths in medical facility reduced from 45,046 (33.4% of all deaths in the year) to 38,673 (23.3%) (APC -2.2%), and deaths in hospice increased from 871 (0.6%) to 24,092 (14.8%) (APC 26.1%). In 2019, men more frequently died in a medical facility than women (25.5% vs. 21.1% of deaths), and women were more likely to die in a nursing home facility than men (12.6% vs. 9.8%). In 2019, individuals aged<65 years died in a medical facility more frequently than those aged ≥65 years (29.8% vs. 21.0%), and also had lower APC for medical facility deaths from 2003– 2019 (APC -1.8% vs. -2.4%). Among groups, NHWs were least likely to die in a medical facility in (21.0% of deaths in 2019) and most likely to die in a hospice facility (15.5% of deaths in 2019). Hispanic individuals (vs. non-Hispanic individuals) had higher rates of home deaths, and lower hospice and nursing home deaths. Conclusions: Despite overall reductions in deaths in medical facilities for people with GI cancers over time, there remain significant sociodemographic disparities. Targeted interventions for care access, economic stability, and social communities are needed to address these findings. PoD for patients with GI cancer.

Data are percentage of total deaths in that group in that year, or APC in deaths in that setting.

Medical Facility

(n = 677,145)
Home

(n = 1,093,626)
Hospice

(n = 240,472)
Nursing Home

(n = 336,511)
2003
2019
APC
2003
2019
APC
2003
2019
APC
2003
2019
APC
Total
33.4
23.3
-2.2
42.1
46.6
0.6
0.6
14.8
26.1
16.5
11.2
-2.4
Men
36.3
25.5
-2.2
43.5
46.4
0.4
0.6
14.6
26.9
13.0
9.8
-2.6
Women
30.5
21.1
-2.3
40.8
46.7
0.9
0.7
14.9
25.3
19.9
12.6
-2.7
Age <65 years
39.7
29.8
-1.8
45.5
44.8
-0.1
0.7
16.1
25.9
7.5
5.8
-2.7
Age ≥65 years
31.2
21.0
-2.4
41.0
47.3
0.9
0.6
14.2
26.3
19.7
13.2
-2.7
Hispanic
41.0
27.7
-2.4
43.1
50.0
1.0
1.1
11.3
18.8
9.4
6.4
-2.3
NHB
45.5
32.5
-2.0
33.5
38.9
1.0
0.58
15.2
27.0
13.4
9.8
-1.8
NHW
30.7
21.0
-2.3
43.8
47.6
0.5
0.6
15.5
27.9
17.4
11.9
-2.3

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach and Other GI Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Cancer Disparities

DOI

10.1200/JCO.2022.40.4_suppl.645

Abstract #

645

Poster Bd #

J4

Abstract Disclosures

Funded by Conquer Cancer

Similar Abstracts

Abstract

2023 ASCO Quality Care Symposium

Access to radiotherapy in Hispanic and Latinx populations in the United States: An update.

First Author: Nicholas Peter Verdini

Abstract

2023 ASCO Quality Care Symposium

Limited health literacy in Hispanic caregivers of children with cancer and childhood cancer survivors.

First Author: Paula Aristizabal