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Palliative care delivery according to age in 12,000 women with metastatic breast cancer: Analysis in the multicentre ESME-MBC cohort 2008-2016
- Source :
- European Journal of Cancer, European Journal of Cancer, Elsevier, 2020, 137, pp.240-249. ⟨10.1016/j.ejca.2020.07.007⟩
- Publication Year :
- 2020
-
Abstract
- Patients with metastatic breast cancer (MBC) often require inpatient palliative care (IPC). However, mounting evidence suggests age-related disparities in palliative care delivery. This study aimed to assess the cumulative incidence function (CIF) of IPC delivery, as well as the influence of age.The national ESME (Epidemio-Strategy-Medical-Economical)-MBC cohort includes consecutive MBC patients treated in 18 French Comprehensive Cancer Centres. ICD-10 palliative care coding was used for IPC identification.Our analysis included 12,375 patients, 5093 (41.2%) of whom were aged 65 or over. The median follow-up was 41.5 months (95% confidence interval [CI], 40.5-42.5). The CIF of IPC was 10.3% (95% CI, 10.2-10.4) and 24.8% (95% CI, 24.7-24.8) at 2 and 8 years, respectively. At 2 years, among triple-negative patients, young patients (65 yo) had a higher CIF of IPC than older patients after adjusting for cancer characteristics, centre and period (65+/65: β = -0.05; 95% CI, -0.08 to -0.01). Among other tumour sub-types, older patients received short-term IPC more frequently than young patients (65+/65: β = 0.02; 95% CI, 0.01 to 0.03). At 8 years, outside large centres, IPC was delivered less frequently to older patients adjusted to cancer characteristics and period (65+/65: β = -0.03; 95% CI, -0.06 to -0.01).We found a relatively low CIF of IPC and that age influenced IPC delivery. Young triple-negative and older non-triple-negative patients needed more short-term IPCs. Older patients diagnosed outside large centres received less long-term IPC. These findings highlight the need for a wider implementation of IPC facilities and for more age-specific interventions.
- Subjects :
- 0301 basic medicine
Cancer Research
medicine.medical_specialty
Palliative care
[SDV]Life Sciences [q-bio]
Psychological intervention
Breast Neoplasms
[SDV.CAN]Life Sciences [q-bio]/Cancer
History, 21st Century
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Older patients
Internal medicine
parasitic diseases
medicine
Humans
cardiovascular diseases
Neoplasm Metastasis
ComputingMilieux_MISCELLANEOUS
Aged
Inpatient care
business.industry
Palliative Care
Age Factors
Cancer
EPICENE
medicine.disease
Metastatic breast cancer
Confidence interval
3. Good health
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Cohort
Female
business
Subjects
Details
- Language :
- English
- ISSN :
- 09598049
- Database :
- OpenAIRE
- Journal :
- European Journal of Cancer, European Journal of Cancer, Elsevier, 2020, 137, pp.240-249. ⟨10.1016/j.ejca.2020.07.007⟩
- Accession number :
- edsair.doi.dedup.....cbdd4f641d640e8cb28a6fc61aaaa9d2