IMR Press / EJGO / Volume 42 / Issue 6 / DOI: 10.31083/j.ejgo4206161
Open Access Original Research
Trends in palliative care and life-sustaining procedure provision for patients with cervical cancer in the United States
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1 Department of Obstetrics and Gynecology, Korea University Medicine, 15459 Ansan, Republic of Korea
2 Department of Health Care Administration and Policy, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89044, USA
3 Department of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Kangwon, Republic of Korea
4 Department of Family Medicine, Chungbuk National University College of Medicine, 28644 Cheongju, Chungbuk, Republic of Korea
5 Department of Family Medicine, Chungbuk National University Hospital, 28644 Cheongju, Chungbuk, Republic of Korea
6 Department of Internal Medicine, School of Medicine, University of Nevada Las Vegas, Las Vegas, NV 89044, USA
7 Department of Endocrinology, First Hospital of Qinhuangdao, 050000 Qinhuangdao, Hebei, China

These authors contributed equally.

Eur. J. Gynaecol. Oncol. 2021 , 42(6), 1105–1111; https://doi.org/10.31083/j.ejgo4206161
Submitted: 16 September 2021 | Revised: 9 October 2021 | Accepted: 14 October 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Objective: This study aimed to identify trends in palliative care (PC) and life-sustaining procedures (LSP) provision and factors related to palliative care provision in patients with cervical cancer in the United States (US). Methods: This serial and cross-sectional study was based on the National Inpatient Sample dataset from 2008 to 2017. The compound annual growth rate (CAGR) was adopted for calculating annual change of PC and LSP. Multivariate logistic regression analyses were used to investigate factors related to PC. Results: The rate of PC consultation in patients with cervical cancer in the US increased steadily from 2.5% in 2008 to 12.8% in 2017 with the CAGR reaching 17.9% (p for trend <0.001). The annual change in the percentage of LSP was not statistically significant in the entire cervical cancer cohort (CAGR = 1.2%, p = 0.623); however, a decreasing tendency was observed over time in the subgroups receiving PC (odds ratio, [95% confidence interval] = 0.95, [0.91–0.99]). Blacks, Hispanics, and Asian/Pacific Islanders were all more likely to receive PC than Caucasians. Patients with Medicaid as the primary payer less frequently received PC consultation than those with Medicare as the primary payer. In addition, the likelihood of undergoing LSPs increased with the severity of the disease. Conclusion: The rate of PC consultation in patients with cervical cancer in the US, although low, is increasing continuously. From a humanitarian perspective, increasing the rate of PC consultation in the treatment trajectory of cervical cancer is important.

Keywords
Palliative care
Uterine cervical neoplasms
Medicaid
National inpatient sample
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