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Palliative care referral in cancer patients with regard to initial cancer prognosis: a population-based study

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorFRASCA, Matthieu
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorORAZIO, Sebastien
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorAMADEO, Brice
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorSABATHE, Camille
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBERTEAUD, Emilie
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGALVIN, Angeline
dc.contributor.authorBURUCOA, Benoit
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorCOUREAU, Gaelle
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBALDI, Isabelle
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorMONNEREAU, Alain
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorMATHOULIN-PELISSIER, Simone
dc.date.accessioned2021-07-06T08:06:03Z
dc.date.available2021-07-06T08:06:03Z
dc.date.issued2021-05-22
dc.identifier.issn0033-3506en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/94989
dc.description.abstractEnOBJECTIVES: More than half of cancer patients require palliative care; however, inequality in access and late referral in the illness trajectory are major issues. This study assessed the cumulative incidence of first hospital-based palliative care (HPC) referral, as well as the influence of patient-, tumor-, and care-related factors. STUDY DESIGN: This is a retrospective population-based study. METHODS: The study included patients from the 2014 population-based cancer registry of Gironde, France. International Classification of Diseases, Tenth Revision, coding for palliative care identified HPC referrals from 2014 to 2018. The study included 8424 patients. Analyses considered the competing risk of death and were stratified by initial cancer prognosis (favorable vs unfavorable [if metastatic or progressive cancer]). RESULTS: The 4-year incidence of HPC was 16.7% (95% confidence interval, 16.6-16.8). Lung cancer led to more referrals, whereas breast, colorectal, and prostatic locations were associated to less frequent HPC compared with other solid tumors. Favorable prognosis central nervous system tumors and unfavorable prognosis hematological malignancies also showed less HPC. The incidence of HPC was higher in tertiary centers, particularly for older patients. In the favorable prognosis subgroup, older and non-deprived patients received more HPC. In the unfavorable prognosis subgroup, the incidence of HPC was lower in patients who lived in rural areas than those who lived in urban areas. CONCLUSIONS: One-sixth of cancer patients require HPC. Some factors influencing referral depend on the initial cancer prognosis. Our findings support actions to improve accessibility, especially for deprived patients, people living in rural areas, those with hematological malignancies, and those treated outside tertiary centers. In addition, consideration of age as factor of HPC may allow for improved design of the referral system.
dc.language.isoENen_US
dc.subject.enPalliative care
dc.subject.enCancer
dc.subject.enHealthcare delivery
dc.subject.enFactor
dc.subject.enCancer registries
dc.subject.enPopulation-based study
dc.title.enPalliative care referral in cancer patients with regard to initial cancer prognosis: a population-based study
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.puhe.2021.03.020en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed34034002en_US
bordeaux.journalPublic Healthen_US
bordeaux.page24-31en_US
bordeaux.volume195en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamBIOSTAT_BPHen_US
bordeaux.teamEPICENE_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03278945
hal.version1
hal.date.transferred2021-07-06T08:06:07Z
hal.exporttrue
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