Summary
Aggressive cancer treatment at the end of life (EOL) is associated with increased emergency department visits, hospital admissions, ICU stays, delayed hospice transition, death in acute care settings, and higher costs. Despite the best efforts of the American Society of Clinical Oncology and the National Quality Form to reduce aggressive cancer treatment at the EOL, there has been no notable decrease and a shift to more expensive and futile treatments.
It is crucial to identify contributors to this upward trend, including patient factors such as race, insurance status, and ECOG performance status, as well as practice-level factors such as case load, practice type and patient diversity. Previous studies have identified practice-level factors associated with cancer treatment but have not explicitly focused on systemic therapy at EOL.
To understand the factors associated with high rates of systemic therapy at EOL for patients with advanced cancers, researchers from Yale School of Medicine and Flatiron Health analyzed a large real-world dataset in this study, including patient factors and practice factors such as census region, practice type, and size.
Why this matters
Continuing treatment beyond the point of benefit can result in adverse outcomes, such as higher rates of hospitalizations and ER visits, increased distress for patients and caregivers, and loss of the opportunity for a peaceful death.
By identifying the factors contributing to the increasing trend of using systemic therapy at the end of life, researchers, healthcare providers, and policymakers can work together to improve end-of-life care for cancer patients and their quality of life.