Hispanic patients with ovarian and cervical cancer, and Asian patients with cervical cancer, are less likely than white patients to utilize palliative care, according to a study.
“Findings from this analysis can inform the practice of health care providers overseeing the recommended cancer treatment course of gynecologic cancer patients. Demonstrating that racial disparities in palliative care utilization among gynecologic cancer patients exist may encourage health care providers to re-examine their treatment recommendations and improve equitable receipt of high-quality cancer care in the United States,” the study authors said of their findings, which appeared in the February issue of Data In Brief.
The study used data from the 2016 National Cancer Database on patients aged 18 to 90 years with metastatic gynecologic cancers including, ovarian, cervical and uterine cancer who were either alive or deceased (n=176,899), as well as patients who were alive at final follow-up (n=66,781). Palliative care was defined as non-curative therapy, including surgery, radiotherapy, chemotherapy, pain management, and a combination of treatments.
The mean age of patients utilizing palliative care was 66 years. Overall, 5% of patients with metastatic gynecologic cancer utilized palliative care. Patients with uterine cancer were more likely to utilize palliative care (11%) than those with cervical (9%) and ovarian cancer (4%). Most patients utilizing palliative care received surgery, radiation, or chemotherapy only (62%); 12% used pain management.
Hispanic patients with ovarian cancer, compared to white patients, were less likely to utilize palliative care (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.68-0.91). When compared to white patients with cervical cancer, the odds of utilizing palliative care were lower for Hispanic (aOR, 0.65; 95% CI, 0.56-0.75) and Asian patients with cervical cancer (aOR, 0.74; 95% CI, 0.59-0.93). No differences were observed among patients with uterine cancer.
Among patients who were still alive at final follow-up, only 3% utilized palliative care. Analyses of racial disparities were made among patients with ovarian and cervical cancer (there were too few patients with uterine cancer utilizing palliative care). In these analyses, no racial disparities were observed.