Trends and Determinants of Location of Death Due to Colorectal Cancer in the United States : A Nationwide Study.

Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
31 Oct 2023
Historique:
received: 08 05 2023
accepted: 09 08 2023
medline: 1 11 2023
pubmed: 1 11 2023
entrez: 1 11 2023
Statut: aheadofprint

Résumé

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States (US); however, there are limited data on location of death in patients who die from CRC. We examined the trends in location of death and determinants in patients dying from CRC in the US. We utilized the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database to extract nationwide data on underlying cause of death as CRC. A multinomial logistic regression was performed to assess associations between clinico-sociodemographic characteristics and location of death. There were 850,750 deaths due to CRC from 2003 to 2019. There was a gradual decrease in deaths in hospital, nursing home, or outpatient facility/emergency department over time and an increase in deaths at home and in hospice. Relative to White decedents, Black, Asian, and American Indian/Alaska Native decedents were less likely to die at home and in hospice compared with hospitals. Individuals with lower educational status also had a lower risk of dying at home or in hospice compared with in hospitals. The gradual shift in location of death of patients who die of CRC from institutionalized settings to home and hospice is a promising trend and reflects the prioritization of patient goals for end-of-life care by healthcare providers. However, there are existing sociodemographic disparities in access to deaths at home and in hospice, which emphasizes the need for policy interventions to reduce health inequity in end-of-life care for CRC.

Sections du résumé

BACKGROUND BACKGROUND
Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States (US); however, there are limited data on location of death in patients who die from CRC. We examined the trends in location of death and determinants in patients dying from CRC in the US.
METHODS METHODS
We utilized the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database to extract nationwide data on underlying cause of death as CRC. A multinomial logistic regression was performed to assess associations between clinico-sociodemographic characteristics and location of death.
RESULTS RESULTS
There were 850,750 deaths due to CRC from 2003 to 2019. There was a gradual decrease in deaths in hospital, nursing home, or outpatient facility/emergency department over time and an increase in deaths at home and in hospice. Relative to White decedents, Black, Asian, and American Indian/Alaska Native decedents were less likely to die at home and in hospice compared with hospitals. Individuals with lower educational status also had a lower risk of dying at home or in hospice compared with in hospitals.
CONCLUSIONS CONCLUSIONS
The gradual shift in location of death of patients who die of CRC from institutionalized settings to home and hospice is a promising trend and reflects the prioritization of patient goals for end-of-life care by healthcare providers. However, there are existing sociodemographic disparities in access to deaths at home and in hospice, which emphasizes the need for policy interventions to reduce health inequity in end-of-life care for CRC.

Identifiants

DOI: 10.1245/s10434-023-14337-y PMID: 37907701
pubmed: 37907701
doi: 10.1245/s10434-023-14337-y
pii: 10.1245/s10434-023-14337-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. Society of Surgical Oncology.

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Auteurs

Swati Sonal (S)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

Bhav Jain (B)

Massachusetts Institute of Technology, Cambridge, MA, USA.

Simar S Bajaj (SS)

Harvard University, Cambridge, MA, USA.

Edward Christopher Dee (EC)

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Chloe Boudreau (C)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
University of Oxford, Oxford, UK.

James C Cusack (JC)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

Hiroko Kunitake (H)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

Robert Goldstone (R)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.
Department of Surgery, Newton-Wellesley Hospital, Newton, MA, USA.

Liliana G Bordeianou (LG)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

Christy E Cauley Md (CE)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

Todd D Francone (TD)

Department of Surgery, Newton-Wellesley Hospital, Newton, MA, USA.
Department of Surgery, Tufts University School of Medicine, Boston, MA, USA.

Rocco Ricciardi (R)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

Motaz Qadan (M)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Department of Surgery, Harvard Medical School, Boston, MA, USA.

David L Berger (DL)

Wang Ambulatory Care Center (WACC) 460, Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. dberger@partners.org.
Department of Surgery, Harvard Medical School, Boston, MA, USA. dberger@partners.org.
ORCID: 0000-0002-0328-4235

Classifications MeSH