Trends in palliative care and life-sustaining procedure provision for patients with cervical cancer in the United States

Abstract

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.